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耳整形术:100例连续患者的经验

Otoplasty: the experience of 100 consecutive patients.

作者信息

Yugueros P, Friedland J A

机构信息

Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA.

出版信息

Plast Reconstr Surg. 2001 Sep 15;108(4):1045-51; discussion 1052-3. doi: 10.1097/00006534-200109150-00038.

Abstract

Although prominent ears are the most common congenital deformity in the head and neck region, only approximately 8 percent of patients who present for treatment of this deformity will have some family history of the abnormality. More than 200 techniques have been described for correction of this deformity, indicating that there is no single widely accepted procedure that has been adopted by most surgeons. The authors of this study present their choice of a procedure that combines the most beneficial features of three previously described techniques and that provides consistently satisfactory results. The surgical technique consists of scoring of the antihelical cartilage on its anterior surface in a subcutaneous position (as described by Stenstrom), suturing to recreate the fold of the antihelix (in the fashion of Mustarde), and concha-mastoid suturing applied to the back of the ear to decrease the concha-scaphoid angle (in the manner of Furnas). The last 100 consecutive patients operated on by the senior author (J.A.F.) over a 10-year period were evaluated. Follow-up data were analyzed using the Kaplan-Meier survival method. The postoperative analysis focused on the incidence of postoperative complications and the overall results of the technique.Most operations were performed bilaterally, on women, and with the patient under local anesthesia. There were few complications, and the incidence of complications was much lower than had been noted in previously reported series. All patients were very satisfied with the improvement in the appearance of their ears. The combined technique presented is safe, easy to perform, and has few complications, and its final outcome is reproducible and long-lasting. It can be considered a standard technique to be used for treating patients of any age and with any magnitude of defect.

摘要

尽管招风耳是头颈部最常见的先天性畸形,但前来治疗这种畸形的患者中,只有约8%有该异常的家族病史。目前已描述了200多种矫正这种畸形的技术,这表明没有一种被大多数外科医生广泛采用的单一方法。本研究的作者介绍了他们选择的一种手术方法,该方法结合了之前描述的三种技术的最有益特征,并能持续提供令人满意的效果。手术技术包括在皮下位置对耳轮软骨前表面进行划痕(如Stenstrom所描述),缝合以重建耳轮折叠(采用Mustarde的方式),以及在耳后应用耳甲-乳突缝合以减小耳甲-舟状窝角(采用Furnas的方式)。对资深作者(J.A.F.)在10年期间连续手术的最后100例患者进行了评估。采用Kaplan-Meier生存方法分析随访数据。术后分析重点关注术后并发症的发生率和该技术的总体效果。大多数手术是双侧进行的,针对女性患者,且患者在局部麻醉下接受手术。并发症很少,其发生率远低于先前报道系列中的记录。所有患者对耳部外观的改善都非常满意。所介绍的联合技术安全、易于实施、并发症少,其最终效果可重复且持久。它可被视为用于治疗任何年龄和任何程度缺陷患者的标准技术。

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