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耳整形手术的精准性:将缩窄性耳整形术与传统耳整形术相结合。

Precision in otoplasty: combining reduction otoplasty with traditional otoplasty.

作者信息

Sinno Sammy, Chang Jessica B, Thorne Charles H

机构信息

New York, N.Y. From the New York University Medical Center, Institute of Reconstructive Plastic Surgery.

出版信息

Plast Reconstr Surg. 2015 May;135(5):1342-1348. doi: 10.1097/PRS.0000000000001225.

Abstract

BACKGROUND

Otoplasty for prominent ears is a routine procedure that is generally met with satisfaction by patients and family members. A significant percentage of patients requesting otoplasty, however, have some degree of macrotia in addition to protruding ears. Combining ear reduction with traditional otoplasty allows correction of these deformities. There are few studies in the literature that describe ear reduction, and those that do, describe small subsets of patients.

METHODS

A retrospective review was performed of the senior author's (C.H.T.) otoplasty procedures from 2010 to 2013. Charts were reviewed for patient demographics, preoperative assessment, surgical technique used, complications, and need for revision. All otoplasty procedures, primary or secondary, were included in the series.

RESULTS

Over a 3-year period, 84 total otoplasty procedures were performed. Of these, 30 patients had some degree of scaphal reduction as a component of the procedure. Five patients (6 percent) also had shortening of the earlobes in addition to the scaphal reduction. Nineteen of the patients (23 percent) had an otoplasty previously (none performed by the senior author) but were not completely satisfied. Complications of reduction otoplasty were limited to a single patient with a suture protrusion behind the ear. None of the patients in this series have required reoperation.

CONCLUSIONS

Scaphal reduction to modify the contour of the upper auricle and/or decrease the overall size of the ear can be a valuable adjunct to otoplasty and may be indicated in a larger than expected percentage of patients presenting for otoplasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

摘要

背景

招风耳整形术是一种常规手术,患者及其家属通常对此感到满意。然而,相当一部分要求进行招风耳整形术的患者除了耳朵突出外,还存在一定程度的巨耳症。将耳部缩小术与传统招风耳整形术相结合可以矫正这些畸形。文献中很少有描述耳部缩小术的研究,即便有,也只是描述了一小部分患者。

方法

对资深作者(C.H.T.)2010年至2013年期间进行的招风耳整形手术进行回顾性研究。查阅病历以了解患者的人口统计学资料、术前评估、所采用的手术技术、并发症以及修复需求。该系列纳入了所有的招风耳整形手术,包括初次手术和二次手术。

结果

在3年时间里,共进行了84例招风耳整形手术。其中,30例患者在手术中进行了一定程度的耳舟缩小术。5例患者(6%)除了耳舟缩小外,还进行了耳垂缩短术。19例患者(23%)之前接受过招风耳整形手术(均非资深作者所做),但并不完全满意。缩小性招风耳整形术的并发症仅限于1例患者,其耳后出现缝线突出。该系列中没有患者需要再次手术。

结论

耳舟缩小术以改变耳廓上部轮廓和/或减小耳朵整体大小,可以作为招风耳整形术的一项有价值的辅助手段,并且在前来接受招风耳整形术的患者中,可能适用于比预期更高比例的患者。

临床问题/证据级别:治疗性,四级。

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