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[312例自体肋软骨鼻耳再造术的并发症]

[Complications in 312 cases of nasal and auricular reconstruction via autologous rib cartilage].

作者信息

Storck K, Bas M, Gurr A, Staudenmaier R, Stark T

机构信息

Klinikum rechts der Isar, Hals-, Nasen-, Ohrenheilkunde, München.

出版信息

Laryngorhinootologie. 2013 Dec;92(12):808-14. doi: 10.1055/s-0033-1351261. Epub 2013 Aug 14.

Abstract

BACKGROUND

We present the results and complications with autologous rib cartilage in comparison to other materials in nasal and auricular reconstruction using a large patient collective from our clinic.

MATERIAL AND METHODS

The retrospective study included all cases of auricular and nasal reconstruction via rib cartilage between 2001 and 2009. The outcome was analysed by subjective and objective parameters.

RESULTS

51/321 patients underwent plastic reconstructive surgery of the nose, 270/321 received a partial or complete auricle reconstruction with autologous rib cartilage. The complication rate e.g. of hematomas, lesions of the pleura, postoperative pain and keloids at the donation site was small. Concerning the aesthetic results of the nose and auricles 273 of 321 (85%) were satisfied after the first operation. Only 3/51 nasal reconstructions underwent a second operation. In case of complete auricular reconstructions, all patients underwent at least 2 operations for the three-dimensional look.

CONCLUSIONS

The use of autologous rip cartilage is still a good option in the auricular and nasal reconstruction. Depending on the expertise of the surgeon the postoperative aesthetic results are good with a low complication rate. However concerning the bigger effort in several aspects for the surgeon as the patient it should be reserved to specific indication criterias.

摘要

背景

我们展示了自体肋软骨在鼻和耳再造中的结果及并发症,并与使用我们诊所大量患者群体的其他材料进行了比较。

材料与方法

这项回顾性研究纳入了2001年至2009年间所有通过肋软骨进行耳和鼻再造的病例。通过主观和客观参数对结果进行分析。

结果

321例患者中,51例行鼻整形重建手术,270例接受了自体肋软骨部分或全耳再造。例如,捐赠部位的血肿、胸膜损伤、术后疼痛和瘢痕疙瘩等并发症发生率较低。关于鼻和耳的美学效果,321例中有273例(85%)在首次手术后感到满意。51例鼻再造中只有3例接受了二次手术。在全耳再造的情况下,所有患者都至少接受了2次手术以获得三维外观。

结论

自体肋软骨在耳和鼻再造中仍然是一个很好的选择。根据外科医生的专业水平,术后美学效果良好,并发症发生率低。然而,由于对外科医生和患者来说在几个方面付出的努力更大,所以应保留给特定的适应证标准。

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