Vincent P L, Voulliaume D, Coudert A, Truy E, Ayari-Khalfallah S
Service de chirurgie plastique, centre hospitalier Saint-Joseph-Saint-Luc, 20, quai Claude-Bernard, 69007 Lyon, France.
Service de chirurgie plastique, centre hospitalier Saint-Joseph-Saint-Luc, 20, quai Claude-Bernard, 69007 Lyon, France.
Ann Chir Plast Esthet. 2019 Aug;64(4):334-343. doi: 10.1016/j.anplas.2018.06.011. Epub 2018 Dec 1.
Auricular deformities therapy by external molding is possible. It must be undertaken early, ideally before the sixth week of life. Persistency of maternal hormones impregnation during the first six weeks of life permits to maintain the malleable cartilages. They can thus be molded into a new position. After the end of this hormonal therapy, the cartilages gradually become rigid in a specific position.
All infants under 6 weeks of age with isolated auricular deformities between July 2015 and July 2016 received a neonatal treatment with an external molding device called EarWell or a custom-made one with silicone. The device was removed when the infant was 6 weeks old and had a treatment duration of at least 4 weeks. A 6 months minimum follow-up was carried out to evaluate the result.
From July 2015 to July 2016, 42 deformed ears were treated in 38 newborns. The average age to apply the device was 2 weeks of life with a treatment duration of 5 weeks. The immediate outcome was evaluated as excellent by the parents in 81% of cases, with an ear judged as "normal" and as excellent by the surgeon in 75% of cases. There were no major complications.
External molding therapy for infants with ear deformities has proved to be effective in 75 to 81% of cases. It is a non-invasive treatment that avoids subsequent surgical treatment for the majority of patients.
通过外部塑形治疗耳廓畸形是可行的。必须尽早进行,理想情况是在出生后第六周之前。在出生后的前六周内,母体激素的持续作用可使软骨保持可塑性。因此,可以将它们塑造成新的形状。在这种激素治疗结束后,软骨会在特定位置逐渐变硬。
2015年7月至2016年7月期间,所有6周龄以下患有孤立性耳廓畸形的婴儿均接受了一种名为EarWell的外部塑形装置或定制硅胶装置的新生儿治疗。当婴儿6周大且治疗持续时间至少为4周时,移除该装置。进行了至少6个月的随访以评估结果。
2015年7月至2016年7月期间,38例新生儿的42只畸形耳接受了治疗。应用该装置的平均年龄为出生后2周,治疗持续时间为5周。81%的病例中,父母对即时效果的评价为优秀,外科医生在75%的病例中判断耳朵为“正常”且效果优秀。没有重大并发症。
事实证明,对于耳部畸形婴儿的外部塑形治疗在75%至81%的病例中是有效的。这是一种非侵入性治疗方法,可避免大多数患者后续进行手术治疗。