Staindl Otto, Siedek Vanessa
University Clinic for Ear, Nose and Throat Medicine and Head and Neck Surgery, Paracelsus Medizinische Privatuniversität, Salzburg, Austria.
GMS Curr Top Otorhinolaryngol Head Neck Surg. 2007;6:Doc03. Epub 2008 Mar 14.
The risk of complications of auricular correction is underestimated. There is around a 5% risk of early complications (haematoma, infection, fistulae caused by stitches and granulomae, allergic reactions, pressure ulcers, feelings of pain and asymmetry in side comparison) and a 20% risk of late complications (recurrences, telehone ear, excessive edge formation, auricle fitting too closely, narrowing of the auditory canal, keloids and complete collapse of the ear). Deformities are evaluated less critically by patients than by the surgeons, providing they do not concern how the ear is positioned. The causes of complications and deformities are, in the vast majority of cases, incorrect diagnosis and wrong choice of operating procedure. The choice of operating procedure must be adapted to suit the individual ear morphology. Bandaging technique and inspections and, if necessary, early revision are of great importance for the occurence and progress of early complications, in addition to operation techniques. In cases of late complications such as keloids and auricles that are too closely fitting, unfixed full-thickness skin flaps have proved to be the most successful. Large deformities can often only be corrected to a limited degree of satisfaction.
耳廓矫正并发症的风险被低估了。早期并发症(血肿、感染、缝线引起的瘘管和肉芽肿、过敏反应、压疮、疼痛以及两侧对比时的不对称感)的风险约为5%,晚期并发症(复发、“电话耳”、边缘过度形成、耳廓贴合过紧、耳道狭窄、瘢痕疙瘩和耳朵完全塌陷)的风险为20%。如果不涉及耳朵的位置问题,患者对畸形的评估不如外科医生严格。在绝大多数情况下,并发症和畸形的原因是诊断错误和手术方式选择不当。手术方式的选择必须根据个体耳朵形态进行调整。除了手术技术外,包扎技术、检查以及必要时的早期修复对早期并发症的发生和发展至关重要。对于瘢痕疙瘩和贴合过紧的耳廓等晚期并发症,未固定的全厚皮瓣已被证明是最成功的。大的畸形往往只能在有限程度上得到满意的矫正。