Seoul, Republic of Korea.
From the Seoul Center for Developmental Ear Anomalies and the Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital.
Plast Reconstr Surg. 2018 Mar;141(3):713-724. doi: 10.1097/PRS.0000000000004183.
The surgical correction of microtias with constricted ear features has remained a challenge because of the variable shape and large volume of the remnant cartilage and skin involved. To clarify how this remnant cartilage and skin should be treated, the authors have reviewed and analyzed cases operated on at their center.
A total of 167 cases of microtia with constricted ear features, operated on from 1992 to 2014, were included in the study. They were reviewed through medical records and photographs, analysis of surgical methods, and postoperative outcomes.
A total of 141 cases (84 percent) were followed for 2 months to 13 years (average, 28 months). The average score given for the aesthetic outcomes, rated on a four-point Likert scale (i.e., 1 = poor, 2 = fair, 3 = good, and 4 = excellent), was 3.1. For framework construction, the authors used remnant cartilage-saving methods (n = 37) or remnant cartilage-replacement methods (n = 104). The average scores for the aesthetic outcome for these methods were 2.56 (median, 3) and 3.36 (median, 4), respectively. The difference in these scores was statistically significant (p < 0.001). For the coverage of new frameworks, various flap techniques were used.
To correct microtias with constricted ear features with consistent postoperative results, the deformed cartilage remnant should be completely replaced with a costal cartilage framework, and the remnant skin should be maximally saved.
由于涉及的残余软骨和皮肤形状和体积多变，因此具有紧缩耳特征的小耳畸形的手术矫正仍然是一个挑战。为了阐明如何处理这些残余软骨和皮肤，作者回顾和分析了在其中心进行的手术病例。
研究共纳入 1992 年至 2014 年间手术治疗的 167 例具有紧缩耳特征的小耳畸形患者。通过病历和照片回顾、手术方法分析和术后结果分析进行回顾。
共 141 例（84%）患者随访 2 个月至 13 年（平均 28 个月）。根据四点 Likert 量表（即 1 = 差，2 = 一般，3 = 好，4 = 优）对美学效果进行评分，平均得分为 3.1。对于框架构建，作者使用残余软骨保存方法（n = 37）或残余软骨置换方法（n = 104）。这两种方法的美学效果平均评分为 2.56（中位数为 3）和 3.36（中位数为 4），差异具有统计学意义（p < 0.001）。对于新框架的覆盖，使用了各种皮瓣技术。
为了获得一致的术后结果，矫正具有紧缩耳特征的小耳畸形，应将变形的软骨残余物用肋软骨框架完全替换，最大限度地保存残余皮肤。
