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自体耳软骨供区的并发症

Donor-site morbidity of ear cartilage autografts.

作者信息

Mischkowski Robert A, Domingos-Hadamitzky Catarina, Siessegger Matthias, Zinser Max J, Zöller Joachim E

机构信息

Köln, Germany From the Department of Craniomaxillofacial and Plastic Surgery, University of Cologne; Department of Visceral, Trauma, and Vascular Surgery, Porz am Rhein Hospital; and Aesthetische Medizin Köln.

出版信息

Plast Reconstr Surg. 2008 Jan;121(1):79-87. doi: 10.1097/01.prs.0000293879.46560.4c.

Abstract

BACKGROUND

The external ear provides a versatile cartilage source for reconstructive procedures, especially for augmentative rhinoplasty. The authors evaluated the short- and long-term morbidity associated with ear cartilage harvest using concha, tragus, and scapha as donor sites.

METHODS

The study included 52 patients in whom a cartilage graft from the external ear was harvested between February of 2001 and June of 2005. Donor-site morbidity was assessed in the early postoperative follow-up period. Twenty-eight patients were examined within a follow-up time of 3 to 168 months. Long-term morbidity assessment included documentation of patients' subjective complaints, clinical examination of the donor site, and anthropometric measurements.

RESULTS

The relevant morbidity factors in the early postoperative period were hematoma formation (6.7 percent) and sensory impairment (3.3 percent). In long-term follow-up, sensory impairment was the most frequent condition objectively assessed and subjectively complained of (12.9 percent). Overall, sensory impairment was confined to concha as the donor site. Anthropometric measurements showed a mean difference in the length of the affected ear compared with the contralateral ear of 1.8 mm, a width difference of 2.5 mm, a difference in tragus/lateral canthus distance of 1.4 mm, and a difference in protrusion angle of 2.4 degrees. Statistically significant differences between values obtained from operated and nonoperated ears could not be detected for every evaluated parameter using the paired t test. Aesthetically relevant complications were rare and their occurrence restricted to single cases.

CONCLUSION

Cartilage graft harvest from the auricle can be considered as a relatively safe procedure with a favorable aesthetic outcome.

摘要

背景

外耳为重建手术,尤其是隆鼻术提供了一种多功能的软骨来源。作者评估了使用耳甲、耳屏和耳舟作为供区获取耳软骨的短期和长期并发症。

方法

研究纳入了52例在2001年2月至2005年6月期间接受外耳软骨移植的患者。在术后早期随访期间评估供区并发症。28例患者在3至168个月的随访期内接受检查。长期并发症评估包括记录患者的主观症状、供区的临床检查以及人体测量。

结果

术后早期的相关并发症因素为血肿形成(6.7%)和感觉障碍(3.3%)。在长期随访中,感觉障碍是客观评估和主观主诉中最常见的情况(12.9%)。总体而言,感觉障碍仅限于以耳甲作为供区的情况。人体测量显示,患耳与对侧耳相比,长度平均差为1.8mm,宽度差为2.5mm,耳屏/外眦距离差为1.4mm,突出角度差为2.4度。使用配对t检验,对于每个评估参数,手术耳和未手术耳获得的值之间未检测到统计学上的显著差异。美学相关并发症罕见,且仅发生在个别病例中。

结论

从耳廓获取软骨移植可被视为一种相对安全的手术,美学效果良好。

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