Mehta Shaun, Gantous Andres
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada3Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, St Joseph's Health Centre, Toro.
JAMA Facial Plast Surg. 2014 Nov-Dec;16(6):414-8. doi: 10.1001/jamafacial.2014.552.
This study evaluates the postoperative outcomes achieved with incisionless otoplasty for the correction of prominauris.
To determine whether incisionless otoplasty is a reliable and replicable technique in correcting prominauris.
DESIGN, SETTING, AND PARTICIPANTS: This study consisted of a retrospective electronic medical record review for 72 patients undergoing incisionless otoplasty for the correction of prominauris by a single surgeon from November 2006 to April 2013. Follow-up ranged from 1 to 87 months. The patients were operated on at both St Joseph's Health Centre (a community hospital) and The Cumberland Clinic (private practice) in Toronto, Ontario, Canada. All patients undergoing an incisionless otoplasty for the correction of prominauris were eligible. Participants' ages ranged from 3 to 55 years, with the majority being adults. Seventy patients were followed up for outcomes.
Incisionless otoplasty.
Number and type of sutures used, perioperative complications, and postoperative follow-up including complications and revisions. Complications included infection, hematoma, bleeding, perichondritis, suture granuloma, suture exposure, and suture failure.
A mean (SD) 2.5 (0.8) sutures were used in the left ear, 2.48 (0.75) in the right ear, and 4.69 (1.75) in total. The number of sutures used in the left vs right ear was not significantly different (P = .60). All patients had horizontal mattress sutures placed for correction of prominauris. There were no serious perioperative complications such as infection, bleeding, hematoma, perichondritis, or cartilage necrosis. Follow-up data were extracted and analyzed in 70 patients, with a mean follow-up time of 31 months. Complications were seen in 10 patients (14%): 4 were due to suture failure, 3 were due to suture exposure, 2 were due to granuloma formation, and 1 was due to a Polysporin (bacitracin zinc/polymyxin B sulfate) reaction. Nine patients (13%) needed a revision to achieve a desirable result.
The technique of incisionless otoplasty used in this study was well tolerated and effective in both pediatric and adult patients, producing favorable outcomes with minimal complications. This procedure is less invasive than its open counterpart and seems at least equally effective in longevity.
本研究评估了无创耳整形术矫正招风耳的术后效果。
确定无创耳整形术在矫正招风耳方面是否为一种可靠且可重复的技术。
设计、地点和参与者:本研究包括对2006年11月至2013年4月间由一名外科医生为72例患者实施无创耳整形术矫正招风耳的回顾性电子病历审查。随访时间为1至87个月。患者在加拿大安大略省多伦多的圣约瑟夫健康中心(一家社区医院)和坎伯兰诊所(私人诊所)接受手术。所有接受无创耳整形术矫正招风耳的患者均符合条件。参与者年龄在3至55岁之间,大多数为成年人。70例患者接受了随访以评估结果。
无创耳整形术。
使用的缝线数量和类型、围手术期并发症以及术后随访情况,包括并发症和修复情况。并发症包括感染、血肿、出血、软骨膜炎、缝线肉芽肿、缝线外露和缝线失效。
左耳平均(标准差)使用2.5(0.8)根缝线,右耳使用2.48(0.75)根缝线,总共使用4.69(1.75)根缝线。左耳和右耳使用的缝线数量无显著差异(P = 0.60)。所有患者均采用水平褥式缝线矫正招风耳。未出现感染、出血、血肿、软骨膜炎或软骨坏死等严重围手术期并发症。对70例患者提取并分析了随访数据,平均随访时间为31个月。10例患者(14%)出现并发症:4例因缝线失效,3例因缝线外露,2例因肉芽肿形成,1例因对多粘菌素(杆菌肽锌/硫酸多粘菌素B)反应。9例患者(13%)需要进行修复以达到理想效果。
本研究中使用的无创耳整形术在儿童和成人患者中耐受性良好且有效,并发症最少,效果良好。该手术比开放式手术侵入性小,且在长期效果上似乎至少同样有效。