Caouette-Laberge L, Guay N, Bortoluzzi P, Belleville C
Division of Plastic Surgery, Hôpital Sainte-Justine, Montreal, Quebec, Canada.
Plast Reconstr Surg. 2000 Feb;105(2):504-15. doi: 10.1097/00006534-200002000-00004.
Corrective otoplasty is a commonly performed procedure to change the shape of the auricular cartilage. Many techniques use permanent sutures to maintain the cartilage folding, whereas other techniques rely on cartilage incisions (partial thickness or full thickness). At this institution, a cartilage cutting and anterior scoring technique has been used for more than 30 years with pleasing results. The surgical techniques published in the past have been reviewed and compared with the procedure used at this institution to point out the advantages, disadvantages, and differences of these various techniques. Also reviewed were 500 consecutive cases operated on under local or general anesthesia between January of 1993 and December of 1995 to determine the incidence of early and late complications. The patients were contacted by mail to return for a follow-up examination or answer a questionnaire, at least 2 years after the procedure. Early complications were bleeding in 13 cases (2.6 percent) and hematoma in 2 cases (0.4 percent). There were no infections or ear necrosis. A small cutaneous wound was present on the anterior skin in three patients (0.6 percent), and there was one wound dehiscence (0.2 percent). Late complications were keloids in two cases and inclusion cysts in three cases. Residual deformity was noted in 22 cases and asymmetry in 28 cases. Secondary surgery was performed in six cases. The questionnaire was answered by 387 patients (77.4 percent response rate): pain when the ear is touched was present in 22 cases (5.7 percent), hypesthesia in 15 cases (3.9 percent), occasional cutaneous irritation in 38 cases (9.8 percent), asymmetry in 71 cases (18.4 percent), and abnormal ear shape in 17 cases (4.4 percent). Twenty-nine patients (7.5 percent) also noted that the ear was more sensitive to cold or touch. The satisfaction rate was 94.8 percent: very satisfied, 74 percent; satisfied, 20.8 percent; dissatisfied, 4.2 percent; and very dissatisfied, 1 percent. These results were compared with other published series of complications and late results after otoplasty; the complication rates are similar or lower in this study. Therefore, it can be concluded that the cartilage cutting and anterior scoring technique otoplasty is a safe procedure with a high patient-parent-surgeon satisfaction rate.
矫正性耳整形术是一种常见的改变耳廓软骨形状的手术。许多技术使用永久性缝线来维持软骨折叠，而其他技术则依赖于软骨切口（部分厚度或全层厚度）。在本机构，一种软骨切割和前侧划痕技术已经使用了30多年，效果令人满意。对过去发表的手术技术进行了回顾，并与本机构使用的手术方法进行了比较，以指出这些不同技术的优缺点和差异。还回顾了1993年1月至1995年12月期间在局部或全身麻醉下连续进行手术的500例病例，以确定早期和晚期并发症的发生率。在手术后至少2年，通过邮件联系患者回来进行随访检查或回答问卷。早期并发症包括13例出血（2.6%）和2例血肿（0.4%）。没有感染或耳部坏死。3例患者（0.6%）前侧皮肤有小的皮肤伤口，1例伤口裂开（0.2%）。晚期并发症包括2例瘢痕疙瘩和3例包涵囊肿。22例有残余畸形，28例不对称。6例进行了二次手术。387例患者（77.4%的回复率）回答了问卷：22例（5.7%）耳部触摸时有疼痛，15例（3.9%）感觉减退，38例（9.8%）偶尔有皮肤刺激，71例（18.4%）不对称，17例（4.4%）耳部形状异常。29例患者（7.5%）还指出耳朵对寒冷或触摸更敏感。满意度为94.8%：非常满意，74%；满意，20.8%；不满意，4.2%；非常不满意，1%。将这些结果与其他已发表的耳整形术后并发症和晚期结果系列进行了比较；本研究中的并发症发生率相似或更低。因此，可以得出结论，软骨切割和前侧划痕技术耳整形术是一种安全的手术，患者-家长-外科医生满意度高。
