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Donor-Site Morbidity Following Harvest of Autologous Costal Cartilage in Microtia Reconstruction
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作者 Surendra Jung Basnet Khushboo Gurung +1 位作者 Satya Raj Paudel Qingguo Zhang 《Modern Plastic Surgery》 2024年第4期57-73,共17页
Objectives: The objective of this study is to evaluate donor-site morbidity after costal cartilage harvest for microtia reconstruction. Methods: A total of 70 patients who underwent autologous costal cartilage harvest... Objectives: The objective of this study is to evaluate donor-site morbidity after costal cartilage harvest for microtia reconstruction. Methods: A total of 70 patients who underwent autologous costal cartilage harvest for microtia reconstruction from March 2008-March 2009 were included. Anterior chest wall deformity was evaluated with chest topography, and scar quality at baseline and at 6-months follow-up, and final outcomes analyzed with SPSS. Results: In 70 patients, 52 (74%) were male, 18 (26%) were female, and altogether 40 (57%) patients developed deformity. At 6-month follow-up, the incidence of anterior chest wall deformity was highest at 80% in Block-III, and least at 0% in Block-I. The 6 - 10 years age group was the largest group at 84% (21), and also with highest incidence of deformity in association to Block-IV harvest at 83%. The incidence of donor-site deformity was higher in female gender at 66%, and 54% in males. But in the sub-group, male had higher incidence of deformity at 75% in both Block-III, and Block-IV when compared to the respective females. The 120 - 135 cm height group had the highest deformity at 67% with Block-IV costal cartilages harvested. At the three measurement points: 1) xiphisternum, 2) intersecting points between PSL and LCM, and 3) intersecting points between MCL and LCM, significant differences (mean) were observed in chest circumference from baseline to 6-month follow-up, and between the left and right chest hemi-circumference (postoperatively). Acceptable donor-site scar was observed in all but 3% (2) developed hypertrophic scar. Conclusion: The development of chest wall deformity was observed when more than one costal cartilage was harvested, particularly the 6th (complete), 7th, 8th block. Therefore, to minimize the deformity, we recommend harvesting only the necessary amount of cartilage, and at the lowest level possible to avoid injury of costochondral junction. Additionally, age, height, gender and chest development are equally important factors which influence donor-site deformity in microtia reconstruction. 展开更多
关键词 Chest Wall Autologous Costal Cartilage DEFORMITY microtia
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Treatment of microtia:past,present and future
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作者 TRIPATHEE Sanjib XIONG Meng 《东南大学学报(医学版)》 CAS 北大核心 2015年第3期485-488,共4页
The purpose of this review article is to review the reconstructive method available for the treatment of microtia and highlight the recent advances.The well established technique developed by Brent and Nagata are stil... The purpose of this review article is to review the reconstructive method available for the treatment of microtia and highlight the recent advances.The well established technique developed by Brent and Nagata are still must widely performed procedure for microtia reconstruction.Various modification of this technique has been reported in the literature.Synthetic framework is seen as an alternative to autogenous costal cartilage framework because of ease of the procedure.More recently,tissue engineering is seen as the most promising treatment.This article gives an overview of the current practice in the field of microtia reconstruction and summarizes the recent surgical developments and relevant tissue engineering research. 展开更多
关键词 microtia anotia autogenous cartilage synthetic framework tissue engineering
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Contemporary solutions for patients with microtia and congenital aural atresia-Hong Kong experience
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作者 Willis S.S.Tsang Michael C.F.Tong +4 位作者 Peter K.M.Ku Kunwar S.S.Bhatia Joannie K.Y.Yu Terence K.C.Wong C.Andrew van Hasselt 《Journal of Otology》 CSCD 2016年第4期-,共8页
Managing microtia patients is always a challenge. Multidisciplinary approach, good family support, well established doctorepatient rela-tionship and well organised patient-support groups are the essential elements for... Managing microtia patients is always a challenge. Multidisciplinary approach, good family support, well established doctorepatient rela-tionship and well organised patient-support groups are the essential elements for success. With the advancement of implantable hearing devices, more options will be available for the microtia patients. Otologists play a leading role in the whole management process. They not only provide proper guidance to the patients in choosing the correct path of the treatment, but also play a key role in organising and maintaining a cost-effective multidisciplinary rehabilitation team for the microtia patients. 展开更多
关键词 microtia Congenital aural atresia Implantable hearing aids Bone conduction
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Application of Autologous Costal Cartilage Scaffold in Reconstruction of Microtia Ear
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作者 Xiao-nan LIAO Xin-xin REN Chen-yang LIU 《Chinese Journal of Plastic and Reconstructive Surgery》 2019年第3期24-27,共4页
Objective To investigate the application effect and manufacturing skills of autologous costal cartilage scaffold in ear reconstruction for microtia.Methods From January 2016 to January 2019,41 patients with microtia r... Objective To investigate the application effect and manufacturing skills of autologous costal cartilage scaffold in ear reconstruction for microtia.Methods From January 2016 to January 2019,41 patients with microtia reconstruction in our hospital were selected,all of whom were type II or type III pediatric deformities.All patients underwent auricle reconstruction and retroauricular skin expansion and autologous costal cartilage stent.The first stage of the operation is to insert a skin dilator behind the residual ear and inject water to expand.The second stage of the operation is to carve and repair the soft ribs(usually 6 or 7 ribs)from the body,make a three-dimensional auricle support for auricle reconstruction,place a negative pressure drainage tube,and follow up for 3 to 6 months to observe the three-dimensional shape of the reconstructed auricle and the formation of cranioauricular angle.Results 41 patients with microtia had good three-dimensional shape of auricle reconstruction,normal auricle position,moderate cranioauricular angle,good helix and triangular fossa structure,and good bilateral symmetry.Patients and their families were satisfied with the effect of auricle reconstruction.Conclusion Autologous costal cartilage is a good scaffold for auricle reconstruction.It is through efficient and elaborate carving and splicing that a good three-dimensional auricle structure can be formed.Combined with early flap expansion,a good postoperative appearance effect can be obtained,which is the appropriate method for auricle reconstruction at present. 展开更多
关键词 microtia Ear reconstruction Skin expansion method Autologous costal cartilage Ear stent
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Temporoparietal Fascia Flaps for Surgical Treatment of Cartilage Exposure After the First-Stage Microtia Reconstruction
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作者 Zhicheng XU Ruhong ZHANG +4 位作者 Qun ZHANG Feng XU Datao LI Yiyuan LI Xia CHEN 《Chinese Journal of Plastic and Reconstructive Surgery》 2021年第2期76-78,共3页
Significant improvements have been achieved in microtia reconstruction using an autogenous costal cartilage framework.However,complications such as skin necrosis and cartilage exposure often destroy the final contour ... Significant improvements have been achieved in microtia reconstruction using an autogenous costal cartilage framework.However,complications such as skin necrosis and cartilage exposure often destroy the final contour of the reconstructed auricle.Local fascia flaps are commonly used in salvage surgery because of their reliability and satisfactory results.Here,we report the case of a 26-year-old woman with multiple skin necroses and cartilage exposure on day 21 after the first-stage microtia reconstruction.The exposure area was covered by a temporoparietal fascia flap as a single-stage procedure.The most essential subunits survived,and the esthetic concours were harmonious and natural at 12 months postoperatively.Temporoparietal fascia flaps are recommended as the surgical treatment for multiple skin necroses and cartilage exposure in microtia reconstruction.The axial-pattern temporoparietal fascia flap is reliable for salvage auricular reconstruction and ensures satisfactory results at long-term follow-up. 展开更多
关键词 microtia Cartilage exposure Temporoparietal fascia flaps
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家庭社会支持系统管理对小耳畸形患儿心理发育的影响
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作者 张英 罗明灿 +2 位作者 李高峰 谭军 刘小加 《国际医药卫生导报》 2024年第14期2427-2431,共5页
目的探究家庭社会支持系统管理对小耳畸形患儿心理发育的影响。方法选取2021年7月至2022年12月在湖南省人民医院行手术治疗的80例小耳畸形患儿作为研究对象,采用随机数字表法将患儿分为对照组(40例)和观察组(40例)。对照组男24例,女16例... 目的探究家庭社会支持系统管理对小耳畸形患儿心理发育的影响。方法选取2021年7月至2022年12月在湖南省人民医院行手术治疗的80例小耳畸形患儿作为研究对象,采用随机数字表法将患儿分为对照组(40例)和观察组(40例)。对照组男24例,女16例;年龄(9.8±2.1)岁;畸形类型:结构畸形9例,耳轮畸形6例,隐耳5例,杯状耳7例,招风耳6例,混合型畸形7例;采用常规随访资助管理。观察组男26例,女14例;年龄(9.6±2.3)岁;畸形类型:结构畸形8例,耳轮畸形7例,隐耳6例,杯状耳6例,招风耳5例,混合型畸形8例;采用家庭社会支持系统管理。两组均干预4周。比较两组患儿干预前后孤独症行为(孤独症行为量表)、自信心(儿童自信心评定量表)及家长满意度(自制满意度评分表)。采用独立样本t检验、配对样本t检验和χ^(2)检验。结果干预后,观察组孤独症行为量表中感觉[(12.4±3.3)分]、躯体运动[(18.4±4.1)分]、生活自理[(13.4±3.5)分]、社会交往[(15.3±4.6)分]、语言[(15.5±4.4)分]评分均低于对照组[(15.7±3.4)分、(21.4±4.4)分、(16.3±3.9)分、(18.4±4.9)分、(18.1±4.8)分],差异均有统计学意义(均P<0.05);观察组儿童自信心评定量表评分[(97.2±12.1)分]高于对照组[(86.6±14.5)分],差异有统计学意义(P<0.05);观察组家长总满意度[97.50%(39/40)]高于对照组[85.00%(34/40)],差异有统计学意义(P<0.05)。结论家庭社会支持系统管理在小耳畸形患儿心理发育方面具有良好的应用效果,可有效改善患儿的行为异常问题,促进心理发育,提高自信心和患儿家长满意度。 展开更多
关键词 小耳畸形 手术 患儿 家庭社会支持系统管理 心理发育 儿童异常行为
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先天性小耳畸形的病因学及临床听力特征分析
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作者 张贤芬 姚智群 邹晓燕 《中国听力语言康复科学杂志》 2024年第6期571-573,578,共4页
目的探讨先天性小耳畸形发病的危险因素以及临床听力学特征。方法对2018~2024年我院儿童听力保健门诊就诊的50例先天性小耳畸形患儿及同期来院就诊的90例健听儿童的临床资料进行回顾性分析。结果50例小耳畸形患儿中,54%为男性,60.9%的... 目的探讨先天性小耳畸形发病的危险因素以及临床听力学特征。方法对2018~2024年我院儿童听力保健门诊就诊的50例先天性小耳畸形患儿及同期来院就诊的90例健听儿童的临床资料进行回顾性分析。结果50例小耳畸形患儿中,54%为男性,60.9%的单侧畸形为右侧受累,70.4%小耳畸形伴外耳道狭窄或闭锁,82%为单发小耳畸形。50例小耳畸形患儿按照Marx分级:Ⅰ级7例,Ⅱ级15例,Ⅲ级28例;平均ABR气导阈值分别为Ⅰ级60.71±7.51 dB nHL、Ⅱ级75.33±2.56 dB nHL、Ⅲ级83.74±2.22 dB nHL,不同分级听力阈值存在显著差异。生活在矿区、孕期前3个月服用上感药物、孕期用药史、出生时低体重等发生小耳畸形的可能性更高。结论生活在矿区、孕期患病、孕期前3个月服用上感药物、孕期用药史、低体重儿等是小耳畸形的高风险因素;小耳畸形程度越重,听力损失越重。 展开更多
关键词 小耳畸形 Marx分级 危险因素 听性脑干反应阈值
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Optimal timing for plastic surgical procedures for common congenital anomalies:A review
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作者 Aakanksha Goel Arun Goel 《World Journal of Clinical Pediatrics》 2024年第2期38-61,共24页
Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents.The global incidence of children... Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents.The global incidence of children born with congenital anomalies has been reported to be 3%-6%with more than 90%of these occurring in low-and middle-income group countries.The exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several reasons.These children are operated under several surgical disciplines,viz,paediatric-,plastic reconstructive,neuro-,cardiothoracic-,orthopaedic surgery etc.These conditions may be life-threatening,e.g.,trachea-oesophageal fistula,critical pulmonary stenosis,etc.and require immediate surgical intervention.Some,e.g.,hydrocephalus,may need intervention as soon as the patient is fit for surgery.Some,e.g.,patent ductus arteriosus need‘wait and watch’policy up to a certain age in the hope of spontaneous recovery.Another extremely important category is that of patients where the operative intervention is done based on their age.Almost all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery(many as multiple stages of correction)at appropriate ages.There are advantages and disadvantages of intervention at different ages.In this article,we present a review of optimal timings,along with reasoning,for surgery of many of the common congenital anomalies which are treated by plastic surgeons.Obstetricians,paediatricians and general practitioners/family physicians,who most often are the first ones to come across such children,must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late. 展开更多
关键词 Plastic surgery Congenital anomalies Pediatric plastic surgery Facial cleft microtia Vascular anomalies SYNDACTYLY HYPOSPADIAS Optimal timing Pediatric surgery
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不同时期导尿对先天性小耳畸形耳廓再造患儿的影响
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作者 伍银 李方伟 +3 位作者 刘菲 李明丽 李秀妹 伍艳群 《国际医药卫生导报》 2024年第2期324-328,共5页
目的探讨不同时期导尿对先天性小耳畸形耳廓再造患儿的影响。方法本研究为随机对照试验。选取2022年1月至12月期间广东省第二人民医院整形美容激光中心的64例先天性小耳畸形耳廓再造术(皮肤扩张法耳廓再造术1期)患者,纳入研究患者年龄(9... 目的探讨不同时期导尿对先天性小耳畸形耳廓再造患儿的影响。方法本研究为随机对照试验。选取2022年1月至12月期间广东省第二人民医院整形美容激光中心的64例先天性小耳畸形耳廓再造术(皮肤扩张法耳廓再造术1期)患者,纳入研究患者年龄(9.3±2.8)岁,男性44例,女性20例。按随机数字表法将其分为对照组和研究组,每组32例。对照组于常规术前在病房行导尿术,研究组于全麻后在手术室行导尿术。分析比较两种护理模式的应用效果,比较不同时期导尿患者的血压、心率变化以及导尿管成功率、疼痛不适感、焦虑恐惧感、尿道损伤发生例数、麻醉复苏时躁动情况。采用χ^(2)检验、t检验。结果对照组导尿前、后收缩压[(16.10±1.96)kPa比(18.14±1.83)kPa]、舒张压[(10.10±1.70)kPa比(10.97±1.64)kPa]、心率[(98.09±1.58)次/min比(120.41±3.90)次/min]比较差异均有统计学意义(t=4.303、2.083、30.006,均P<0.05)。研究组导尿前、后收缩压[(16.39±1.80)kPa比(16.66±2.06)kPa]、舒张压[(10.10±1.70)kPa比(10.50±1.57)kPa]、心率[(98.14±1.61)次/min比(98.93±6.43)次/min]比较差异均无统计学意义(t=0.558、0.978、0.674,均P>0.05)。研究组一次性置入导尿管成功、疼痛不适感、焦虑恐惧、麻醉复苏时躁动患者分别为30、0、8、1例,对照组分别为24、26、30、28例,两组比较差异均有统计学意义(均P<0.05)。结论对先天性小耳畸形耳廓再造患儿采取全麻后行导尿术的全程护理方式,能减轻患儿的心理负担和并发症,提高导尿舒适度,值得在护理临床中推广及应用。 展开更多
关键词 先天性小耳畸形 小耳再造术 全麻 导尿术 儿童
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先天性外中耳畸形患者听性脑干反应与颞骨发育的相关性研究
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作者 金文 王元 +1 位作者 马晓博 赵守琴 《中国耳鼻咽喉头颈外科》 CSCD 2024年第8期492-496,共5页
目的探讨先天性外中耳畸形患者临床早期听性脑干反应(ABR)与远期颞骨发育情况之间的相关性。方法回顾性分析先天性外中耳畸形患者临床资料,包括婴幼儿期ABR、青少年或儿童期颞骨CT及患者基本情况等。比较颞骨发育不同患者间ABR阈值差异... 目的探讨先天性外中耳畸形患者临床早期听性脑干反应(ABR)与远期颞骨发育情况之间的相关性。方法回顾性分析先天性外中耳畸形患者临床资料,包括婴幼儿期ABR、青少年或儿童期颞骨CT及患者基本情况等。比较颞骨发育不同患者间ABR阈值差异。结果Jahrsdoerfer评分及乳突气化程度与ABR气导阈值及气骨导差值负相关,先天性外耳道骨性闭锁患者Jahrsdoerfer评分高组ABR气导阈值(P=0.011)、ABR气骨导差值低于Jahrsdoerfer评分低组(P=0.033)。所有先天性外中耳畸形患者乳突气化型组ABR气导阈值(P=0.005)及气骨导差值(P<0.001)低于非气化型组。先天性外耳道狭窄伴胆脂瘤组ABR气导阈值(P=0.002)及ABR气骨导差(P<0.001)高于不伴胆脂瘤组。结论对先天性外中耳畸形患者而言,婴幼儿时期进行ABR检查不仅可以反映患者听力情况,也具有预测颞骨发育情况的意义。 展开更多
关键词 先天性小耳畸形 诱发电位 听觉 脑干 颞骨 骨发育 预测 先天性外中耳畸形
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耳后筋膜瓣的改良设计及其在颅耳沟重建术中的效果
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作者 李意源 张如鸿 《组织工程与重建外科》 CAS 2024年第2期205-207,共3页
目的评价耳后筋膜的组织形态学特征,并对其进行几何学设计改良,以改善颅耳沟重建术后颅耳沟外观,并减少术后局部并发症的发生。方法对16例患者进行耳后筋膜厚度的超声测量,通过几何学设计得到耳后上筋膜瓣,并将该方法用于125例颅耳沟重... 目的评价耳后筋膜的组织形态学特征,并对其进行几何学设计改良,以改善颅耳沟重建术后颅耳沟外观,并减少术后局部并发症的发生。方法对16例患者进行耳后筋膜厚度的超声测量,通过几何学设计得到耳后上筋膜瓣,并将该方法用于125例颅耳沟重建术。结果耳后筋膜由上至下厚度逐渐增加。耳后上筋膜瓣较传统的耳后筋膜瓣在手术操作上更简单,术后的颅耳沟形态更自然,耳后局部皮肤坏死和瘢痕增生减少。结论最大限度利用接近顶侧耳后筋膜组织设计的改良耳后上筋膜瓣,在手术效果及减少术后并发症方面均优于传统耳后筋膜瓣。 展开更多
关键词 先天性小耳畸形 颅耳沟重建 耳后筋膜 耳后上筋膜瓣
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The growth of ear of paediatric subjects in Hong Kong—A timely reconstruction for unilateral microtia 被引量:2
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作者 Osan Y.M.Ho Peter K.M.Ku +1 位作者 Victor Abdullah Michael C.F.Tong 《中华整形外科杂志》 CAS CSCD 北大核心 2020年第1期76-79,共4页
Objective To establish the local data on the growth of ear in Hong Kong children and provide a reference for the timing of reconstruction in unilateral microtia.Methods We reviewed case notes of paediatric patients up... Objective To establish the local data on the growth of ear in Hong Kong children and provide a reference for the timing of reconstruction in unilateral microtia.Methods We reviewed case notes of paediatric patients up to 18 years of age who had attended our Ear,Nose and Throat Out-patient Clinic from March to November 2017.We recorded the pinna length of these patients and that of their parents,compared the patients’ear length against that of their parents,and investigated any discrepancy of pinna.Results We recruited 226 local individuals(139 males and 87 females).The patients were divided into different age groups.The means of ear length of patients were compared with the mean length of pinna of their parents.Data of boys and girls are analyzed separately.Boys at 7-8 years old achieved 87.33%and 93.54%of their fathers’and mothers’ear length respectively.Girls at 7-8 years old achieved 83.00%and 90.80%of their fathers’and mothers’ear length respectively.Moreover,the average ratio of the length of left and right ear ratio is 97.3%in all groups of children.Conclusions In Hong Kong children,at the age of 7-8 the ear approaches the size of normal adult ear and is the feasible age with less asymmetry after reconstruction of the microtia. 展开更多
关键词 microtia EAR reconstruction auricle GROWTH AURICLE discrepancy
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HMX1基因多态性与绵羊先天小耳畸形的相关性分析
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作者 任亭亭 任思睿 +3 位作者 韩冰 蒋芳芳 刘明军 贺三刚 《家畜生态学报》 北大核心 2024年第8期16-21,共6页
为研究HMX1基因的SNPs多态性及其增强子突变与绵羊先天小耳畸形之间的关系,采用琼脂糖凝胶电泳结合PCR测序技术对170只阿勒泰羊HMX1基因的增强子、外显子的多态性进行检测,并与先天小耳畸形进行关联分析。结果表明:在HMX1基因的外显子1... 为研究HMX1基因的SNPs多态性及其增强子突变与绵羊先天小耳畸形之间的关系,采用琼脂糖凝胶电泳结合PCR测序技术对170只阿勒泰羊HMX1基因的增强子、外显子的多态性进行检测,并与先天小耳畸形进行关联分析。结果表明:在HMX1基因的外显子1和2中共鉴定出24个SNPs,其中A557T与绵羊先天小耳畸形显著相关(P<0.05);在HMX1的基因增强子中发现存在76 bp的复制,与绵羊先天小耳畸形极显著相关(P<0.01)。研究结果显示,HMX1基因增强子区76 bp复制可能是导致阿勒泰绵羊先天小耳畸形的致因突变,这一发现为阿勒泰羊先天小耳畸形的分子诊断和遗传改良提供了潜在的标记。 展开更多
关键词 阿勒泰羊 先天小耳畸形 HMX1基因 SNP 增强子
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Full retroauricular skin and fascia expansion in microtia reconstruction:a single center experience of 166 cases 被引量:1
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作者 Ji-Hua Wang Ting Tang +2 位作者 Yong-Jing He Ying-Jia Zhang Yun Yang 《Plastic and Aesthetic Research》 2016年第1期364-367,共4页
Aim:Ear reconstruction is a challenge for plastic and reconstructive surgeons.The ear requires sufficient skin coverage and a three-dimensional(3D)cartilage framework.In this paper,the authors present their 10-year ex... Aim:Ear reconstruction is a challenge for plastic and reconstructive surgeons.The ear requires sufficient skin coverage and a three-dimensional(3D)cartilage framework.In this paper,the authors present their 10-year experience in microtia reconstruction using tissue expansion and an autogenous rib cartilage framework.Methods:Ear reconstruction was performed in 3 operative stages.During the first procedure,a 50-80 mL kidney or cylinder-shaped expander was implanted deep to the subcutaneous fascia of the retroauricular mastoid region.Over a period of 3-5 months,the expander was filled to a final volume of 80-110 mL.In the next operation,the retroauricular fascia was eliminated or reserved following expander removal,and the autogenous costal cartilage framework was placed below the expanded skin flap.At the third and final stage,the earlobe transposition,tragus construction and conchal deepening were performed.Results:A total of 165 patients(166 ears)were reconstructed using tissue expansion and an autogenous rib cartilage framework.Complications included hematomas in 3 cases,expander exposure in 8 cases,cartilage exposure in 6 cases,infection and cartilage resorption in 2 cases,exposure of steel wire in 4 cases,and aseptic seroma in 2 cases.Follow-up ranging from 3 months to 5 years showed that 159 patients were satisfied with the reconstructed ear including size,location,projection,convolution,skin-colour matching,symmetry with opposite ear.Conclusion:Expansion of the retroauricular skin and fascia can provide sufficient non-hair-bearing skin and tissue for coverage of a three-dimensional costal cartilage framework.Avoidance and prompt treatment of complications are advised in order to obtain a satisfactory reconstruction of the ear. 展开更多
关键词 microtia EXPANSION autogenous costal cartilage ear reconstruction
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Rib Cartilage Assessment Relative to the Healthy Ear in Young Children with Microtia Guiding Operative Timing
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作者 Shen-Song Kang Ying Guo +1 位作者 Dong-Yi Zhang Du-Yin Jiang 《Chinese Medical Journal》 SCIE CAS CSCD 2015年第16期2208-2214,共7页
Background:The optimal age at which to initiate for auricular reconstruction is controversial.Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction.We ... Background:The optimal age at which to initiate for auricular reconstruction is controversial.Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction.We developed a method to guide the timing of auricular reconstruction in children with microtia ranging in age from 5 to 10 years.Methods:Rib cartilage and the healthy ear were assessed using low-dose multi-slice computed tomography.The lengths of the eighth rib cartilage and the helix of the healthy ear (from the helical crus to the joint of the helix and the earlobe) were measured.Surgery was performed when the two lengths were approximately equal.Results:The preoperative eighth rib measurements significantly correlated with the intraoperative measurements (P 〈 0.05).From 5 to 10 years of age,eighth rib growth was not linear.In 76 (62.8%) of 121 patients,the eighth rib length was approximately equal to the helix length in the healthy ear;satisfactory outcomes were achieved in these patients.In 18 (14.9%) patients,the eighth rib was slightly shorter than the helix,helix fabrication was accomplished by adjusting the length of the helical crus of stent,and satisfactory outcomes were also achieved.Acceptable outcomes were achieved in 17 (14.0%) patients in whom helix fabrication was accomplished by cartilage splicing.In 9 (7.4%) patients with insufficient rib cartilage length,the operation was delayed.In one (0.8%) patient with insufficient rib cartilage length,which left no cartilage for helix splicing,the result was unsatisfactory.Conclusions:Eighth rib cartilage growth is variable.Rib cartilage assessment relative to the healthy ear can guide auricular reconstruction and personalize treatment in young patients with microtia. 展开更多
关键词 CARTILAGE Computed Tomography microtia Otologic Surgical Procedures Transplantation
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治疗轻、中度杯状耳的临床路径探索
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作者 尤海瑞 金升元 《中国医疗美容》 2024年第2期23-26,共4页
目的探索联合多种方法,以新的临床方法治疗轻、中度杯状耳畸形。方法将纳入研究范围患耳分成若干问题部分,按照矫正大小、纠正局部畸形、调整患耳空间位置次序,灵活组合运用既往成熟杯状耳手术方法纠正患耳畸形。结果治疗的14例(共25耳)... 目的探索联合多种方法,以新的临床方法治疗轻、中度杯状耳畸形。方法将纳入研究范围患耳分成若干问题部分,按照矫正大小、纠正局部畸形、调整患耳空间位置次序,灵活组合运用既往成熟杯状耳手术方法纠正患耳畸形。结果治疗的14例(共25耳)中,所有患者对拆线时效果满意,半年后随访,有13例对效果满意,1例自觉双耳轻微不对称,不同意继续纠正治疗。结论把杯状耳分成三个可调整部分,按次序治疗畸形,这不仅给治疗杯状耳畸形带来了新思路,被治疗的患者也会更加自信。 展开更多
关键词 杯状耳畸形 小耳畸形 垂耳畸形
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个性化护理随访在先天性小耳畸形耳廓再造中的应用评价 被引量:2
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作者 伍艳群 蓝建珍 +2 位作者 王笋娟 李友瑾 潘小欢 《国际医药卫生导报》 2023年第3期439-443,共5页
目的探讨个性化护理随访在先天性小耳畸形耳廓再造中的应用。方法本研究为随机对照试验。选取2018年1月至2020年1月广东省第二人民医院收治的先天性小耳畸形患儿120例作为研究对象,均给予全耳廓再造术治疗。按随机数字表法将其分为对照... 目的探讨个性化护理随访在先天性小耳畸形耳廓再造中的应用。方法本研究为随机对照试验。选取2018年1月至2020年1月广东省第二人民医院收治的先天性小耳畸形患儿120例作为研究对象,均给予全耳廓再造术治疗。按随机数字表法将其分为对照组和观察组,各60例。对照组男51例、女9例,年龄(8.2±1.9)岁,给予常规护理;观察组男43例、女17例,年龄(8.4±2.1)岁,给予常规护理加个性化护理随访。对比两组患儿术后并发症发生率,包括再造耳外形臃肿、耳支架外露、切口感染等;同时对两组患儿进行固定时间随访,于不同时间点对比两组患儿家属满意度。采用χ^(2)检验、独立样本t检验。结果经护理后,观察组不良反应发生率为1.7%(1/60),低于对照组13.3%(8/60),差异有统计学意义(χ^(2)=5.886,P=0.015)。观察组患儿家属总满意度为100.0%(60/60),高于对照组90.0%(54/60),差异有统计学意义(χ^(2)=6.316,P=0.012)。结论个性化护理随访在先天性小耳畸形耳廓再造中可显著降低并发症发生率,并提高患儿家属满意度。 展开更多
关键词 先天性小耳畸形 耳廓再造 个性化护理随访
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3D printing of personalized polylactic acid scaffold laden with GelMA/autologous auricle cartilage to promote ear reconstruction 被引量:1
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作者 Xingyu Gui Zhiyu Peng +13 位作者 Ping Song Li Chen Xiujuan Xu Hairui Li Pei Tang Yixi Wang Zixuan Su Qingquan Kong Zhenyu Zhang Zhengyong Li Ying Cen Changchun Zhou Yujiang Fan Xingdong Zhang 《Bio-Design and Manufacturing》 SCIE EI CAS CSCD 2023年第4期451-463,共13页
At present,the clinical reconstruction of the auricle usually adopts the strategy of taking autologous costal cartilage.This method has great trauma to patients,poor plasticity and inaccurate shaping.Three-dimensional... At present,the clinical reconstruction of the auricle usually adopts the strategy of taking autologous costal cartilage.This method has great trauma to patients,poor plasticity and inaccurate shaping.Three-dimensional(3D)printing technology has made a great breakthrough in the clinical application of orthopedic implants.This study explored the combination of 3D printing and tissue engineering to precisely reconstruct the auricle.First,a polylactic acid(PLA)polymer scaffold with a precisely customized patient appearance was fabricated,and then auricle cartilage fragments were loaded into the 3D-printed porous PLA scaffold to promote auricle reconstruction.In vitro,gelatin methacrylamide(GelMA)hydrogels loaded with different sizes of rabbit ear cartilage fragments were studied to assess the regenerative activity of various autologous cartilage fragments.In vivo,rat ear cartilage fragments were placed in an accurately designed porous PLA polymer ear scaffold to promote auricle reconstruction.The results indicated that the chondrocytes in the cartilage fragments could maintain the morphological phenotype in vitro.After three months of implantation observation,it was conducive to promoting the subsequent regeneration of cartilage in vivo.The autologous cartilage fragments combined with 3D printing technology show promising potential in auricle reconstruction. 展开更多
关键词 microtia 3D printing Polylactic acid(PLA)polymer scaffolds Gelatin methacrylamide Cartilage reconstruction
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外中耳畸形患者人工耳蜗植入的注意事项 被引量:2
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作者 刘军 《中国听力语言康复科学杂志》 2023年第2期121-124,共4页
重度-极重度感音性聋且助听器验配效果不佳是人工耳蜗植入的适应证。当人工耳蜗植入患者合并外中耳畸形时,术前评估、手术和术后康复有其特点。外中耳畸形患者需完成听力学和助听器效果评估,外耳道闭锁可对纯音测听、声导抗、耳声发射... 重度-极重度感音性聋且助听器验配效果不佳是人工耳蜗植入的适应证。当人工耳蜗植入患者合并外中耳畸形时,术前评估、手术和术后康复有其特点。外中耳畸形患者需完成听力学和助听器效果评估,外耳道闭锁可对纯音测听、声导抗、耳声发射和气导ABR阈值的检查产生影响,需结合骨导ABR阈值检测。影像学评估包括CT和磁共振成像,以明确解剖结构,有助于确定手术计划。外中耳畸形患者行人工耳蜗植入手术时需关注手术入路的解剖是否异常,尤其是面神经畸形、内耳畸形,备面神经监测和术中CT,避免损伤面神经,确保电极植入位置准确;整形和听功能重建均十分重要,需设计切口,尽量减少对后期矫正耳廓畸形手术的影响。因患者无正常的耳廓悬挂,所以术后需要使用特殊设计的言语处理器。术后疗效评估包括听阈、言语识别率、有意义听觉整合量表(meaningful auditor integration scale,MAIS)/听觉行为分级问卷(CAP)等问卷可了解患者的听说能力,与外中耳形态正常人群相似。当外中耳畸形患者需要进行人工耳蜗植入时要考虑其解剖、手术的特殊性,减少并发症的发生。 展开更多
关键词 小耳畸形 外耳道闭锁 人工耳蜗植入 面神经畸形 疗效 评估
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产前超声经颅底横断面评估胎儿鼓室环
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作者 王珊珊 李雪蕾 +2 位作者 黄婷 王明莉 郑慧 《中国医学影像学杂志》 CSCD 北大核心 2023年第3期266-270,274,共6页
目的产前超声经颅底横断面观察12~31+6周胎儿鼓室环的发育情况,预测胎儿外耳道的发育。资料与方法回顾性纳入2020年7月-2021年9月在安徽省妇幼保健院进行产前超声检查并经颅底横断面测量鼓室环前后径的238例胎儿,于出生或引产后确认其... 目的产前超声经颅底横断面观察12~31+6周胎儿鼓室环的发育情况,预测胎儿外耳道的发育。资料与方法回顾性纳入2020年7月-2021年9月在安徽省妇幼保健院进行产前超声检查并经颅底横断面测量鼓室环前后径的238例胎儿,于出生或引产后确认其耳廓及外耳道的发育情况。分析正常胎儿与耳廓畸形及外耳道闭锁或狭窄胎儿鼓室环前后径、外耳廓长径的差异,并分析正常胎儿鼓室环前后径与孕周、外耳廓长的相关性。结果238例胎儿中,10例单侧小耳畸形合并外耳道闭锁,1例右侧小耳畸形、左侧耳廓形态异常合并双侧外耳道闭锁,1例左侧小耳畸形合并外耳道狭窄。12例外耳道闭锁侧产前超声鼓室环均未显示,1例外耳道狭窄侧鼓室环明显小于正常侧。正常胎儿不同孕周左、右侧鼓室环前后径、外耳廓长径差异均无统计学意义(t=-0.541~0.153、-0.696~1.136,P均>0.05)。正常胎儿与异常胎儿患侧鼓室环前后径、外耳廓长径差异均有统计学意义(P均<0.001)。异常胎儿健侧与患侧鼓室环前后径、外耳廓长径差异均有统计学意义(P均<0.001)。正常胎儿与异常胎儿健侧鼓室环前后径、外耳廓长径差异均无统计学意义(P均>0.05)。正常胎儿鼓室环前后径与孕周、外耳廓长径的相关性较好(r2=0.775、0.745,P均<0.001)。结论胎儿鼓室环是外中耳发育异常的可靠指标,其前后径随孕周及外耳廓长径增加而增长,中孕期超声评估鼓室环是可行的,评估鼓室环的发育可以帮助临床解决产前诊断外耳道闭锁、狭窄的难题,有助于产前及产后进行多学科咨询。 展开更多
关键词 鼓室环 外耳道闭锁 小耳畸形 超声检查 胎儿
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