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小耳畸形患者的术后安全性和满意度。

Postoperative Safety and Satisfaction in Patients With Microtia.

机构信息

Professor, Pediatric Craniofacial Surgeon, Hospital del Niño y el Adolescente Morelense, Morelos, México; Chair Departament of Oral maxilofacial surgery of Hospital Regional de La Orinoquia, Casanare, Colombia.

Chair, Pediatric Craniofacial Surgeon, Departament of craniofacial surgery of Hospital del Niño y el Adolescente Morelense, Morelos, México.

出版信息

J Oral Maxillofac Surg. 2021 Feb;79(2):472.e1-472.e9. doi: 10.1016/j.joms.2020.09.004. Epub 2020 Sep 8.

Abstract

PURPOSE

The reconstructive approach for microtia should employ a surgical technique that reconstructs the atrial anatomy; therefore, multiple surgical techniques have been described, and these have undergone variations due to adaptation by different authors. This study aims to assess the postoperative safety and satisfaction of patients with microtia undergoing surgery with the ear reconstruction technique.

METHODS

A retrospective cohort study was performed in patients undergoing ear reconstruction with costochondral grafts. The patients were treated in the craniomaxillofacial surgery services of hospitals in Mexico and Colombia from 2008 to 2018. All medical records from the entire study population were included, including complete photographic records and informed consents. A descriptive analysis was performed to characterize the clinical variables and complications. Bivariate analysis was performed using Fisher's exact χ test to explore the relationship between clinical and demographic variables with respect to complications.

RESULTS

A total of 410 patients were followed for a period of 12 to 16 months. Only 10% of the sample presented some type of complication. A common complication was dehiscence of the atrial area (23 patients), as well as poor anatomical reproduction (7 patients) due to the collapse of the drainage tubes in the first postoperative phase. No connection was found between the presence of complications and side or type, and no congenital anomalies were found to be associated with microtia (P > .05). The helix and the antihelix were the anatomical areas with greater satisfaction scores.

CONCLUSIONS

Costochondral cartilage is the gold standard reconstruction technique; the results of this study suggest a low complication rate and high scores of satisfaction after reconstruction. However, the technique requires constant adaptation to obtain better satisfaction results.

摘要

目的

小耳畸形的重建方法应采用重建心房解剖结构的手术技术;因此,已经描述了多种手术技术,并且由于不同作者的适应,这些技术已经发生了变化。本研究旨在评估接受耳再造术的小耳畸形患者的术后安全性和满意度。

方法

对 2008 年至 2018 年在墨西哥和哥伦比亚医院的颅面外科服务中接受肋软骨移植耳再造术的患者进行回顾性队列研究。纳入了所有研究人群的完整病历记录,包括完整的照片记录和知情同意书。采用描述性分析对临床变量和并发症进行特征描述。采用 Fisher's 确切 χ 检验进行双变量分析,以探讨临床和人口统计学变量与并发症之间的关系。

结果

共随访了 410 例患者,随访时间为 12 至 16 个月。只有 10%的样本出现了某种类型的并发症。一种常见的并发症是心房区域的裂开(23 例),以及由于引流管在术后第一阶段塌陷导致解剖结构复制不良(7 例)。并发症的存在与侧别或类型之间没有发现联系,也没有发现与小耳畸形相关的先天性异常(P>.05)。螺旋和反螺旋是解剖区域满意度评分较高的部位。

结论

肋软骨是重建的金标准技术;本研究结果表明,重建后的并发症发生率低,满意度评分高。然而,该技术需要不断适应,以获得更好的满意度结果。

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