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使用自体肋软骨进行耳再造:陡峭的学习曲线。

Ear Reconstruction Using Autologus Costal Cartilage: A Steep Learning Curve.

作者信息

Ladani Paritkumar S, Valand Rajesh, Sailer Hermann

机构信息

Swiss Cleft and Craniofacial Centre, BSES MG Hospital, S.V. Road, Opp. Andheri (W) Railway Station, Andheri West, Mumbai, Maharashtra 400058 India.

出版信息

J Maxillofac Oral Surg. 2019 Sep;18(3):371-377. doi: 10.1007/s12663-018-1158-4. Epub 2018 Oct 1.

Abstract

PURPOSE

Ear reconstruction is a challenging operation with a steep learning curve. In view of its rarity, attaining a high standard for new surgeons is extremely difficult. This study describes the author's experience of 53 ear reconstructions using costal cartilage for congenital and post-traumatic ear deformity.

METHODS

The author performed 53 autologous ear reconstructions for microtia and post-traumatic ear defect over a period of 5 years utilizing the two-stage technique popularized by Firmin in most of the cases. An assessment of complications, pattern of progress and aesthetic outcome of the reconstructed ears was carried out.

RESULTS

There were 4 cases of partial skin necrosis. In early cases, deficiencies were seen in the proportions of the reconstructed ear and the quality of definition. Better shape and definition were evident as more surgical experience was gained. This occurred as a result of increased appreciation of the ear proportions and improved framework carving.

CONCLUSIONS

The series demonstrates the early learning curve in microtia reconstruction and underlines the importance of appropriate training and case availability in achieving high-quality results in autologous ear reconstruction.

摘要

目的

耳部重建是一项具有挑战性的手术,学习曲线较陡。鉴于其罕见性,让新外科医生达到高标准极其困难。本研究描述了作者使用肋软骨进行53例先天性和创伤后耳部畸形耳部重建的经验。

方法

作者在5年时间里对小耳畸形和创伤后耳部缺损进行了53例自体耳部重建,大多数病例采用了由菲尔明推广的两阶段技术。对重建耳部的并发症、进展模式和美学效果进行了评估。

结果

有4例出现部分皮肤坏死。在早期病例中,重建耳部的比例和清晰度存在不足。随着手术经验的增加,耳部形状和清晰度明显改善。这是由于对耳部比例的认识提高和框架雕刻技术改进所致。

结论

该系列病例展示了小耳畸形重建的早期学习曲线,并强调了在自体耳部重建中获得高质量结果时适当培训和病例数量的重要性。

相似文献

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Ear Reconstruction Using Autologus Costal Cartilage: A Steep Learning Curve.使用自体肋软骨进行耳再造:陡峭的学习曲线。
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本文引用的文献

1
Early experience in microtia reconstruction: the first 100 cases.小耳畸形重建的早期经验:前 100 例。
J Plast Reconstr Aesthet Surg. 2011 Apr;64(4):452-8. doi: 10.1016/j.bjps.2010.07.027. Epub 2010 Aug 23.
2
The learning curve in microtia surgery.耳郭畸形手术的学习曲线
Facial Plast Surg. 2009 Aug;25(3):164-8. doi: 10.1055/s-0029-1239445. Epub 2009 Oct 6.
5
Advances in the treatment of microtia.小耳畸形治疗的进展
Curr Opin Otolaryngol Head Neck Surg. 2006 Dec;14(6):412-22. doi: 10.1097/MOO.0b013e328010633a.
6
Reconstruction of the auricle.耳廓重建
Br J Plast Surg. 2002 Dec;55(8):645-51. doi: 10.1054/bjps.2002.3966.

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