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耳部畸形。

Ear Abnormalities.

机构信息

Division of Plastic Surgery, Nicklaus Children's Hospital, Miami, FL.

Division of Plastic Surgery, Florida International University College of Medicine, Miami, FL.

出版信息

Pediatr Rev. 2021 Apr;42(4):180-188. doi: 10.1542/pir.2019-0167.

Abstract

Congenital ear abnormalities present an aesthetic and psychosocial concern for pediatric patients and their parents. Diagnosis of external ear deformities is based on clinical examination and is facilitated by an understanding of normal ear anatomy. Ear anomalies can be categorized as malformations or deformations. Malformations are characterized by absent anatomical structures of the ear (or absence of the ear itself), as exemplified by microtia and anotia. Ear deformations are characterized by ear anatomical landmarks that are present but are distorted or abnormal, with Stahl ear, constricted ear, and prominent ear being common presentations. Ear malformations will not improve with growth of the patient and uniformly require surgical intervention to recreate an anatomically typical ear. Although a small percentage of ear deformations can self-resolve, most patients with ear deformations will require nonsurgical or surgical reconstruction to achieve a normal or more aesthetic ear. In recent decades the use of nonsurgical ear splinting or molding has been recognized as a highly effective method in correcting a variety of congenital ear deformations when treatment is initiated in the first 8 weeks of life. The urgency in initiating nonsurgical treatment of ear deformations at an early age makes prompt recognition of these ear deformations essential because surgical correction remains the only viable reconstructive option in older infants and children.

摘要

先天性耳部畸形会给儿科患者及其家长带来美观和心理社会问题。外耳畸形的诊断基于临床检查,并需要了解正常的耳部解剖结构。耳部畸形可分为畸形或变形。畸形的特征是耳部解剖结构缺失(或耳部本身缺失),例如小耳畸形和无耳畸形。耳部变形的特征是耳部解剖标志存在,但扭曲或异常,常见的表现有 Stahl 耳、缩窄耳和招风耳。随着患者的生长,耳部畸形不会自行改善,需要进行手术干预以重建具有典型解剖结构的耳朵。虽然一小部分耳部变形可以自行缓解,但大多数耳部变形的患者需要非手术或手术重建以获得正常或更美观的耳朵。在过去几十年中,人们认识到,在生命的头 8 周内开始使用非手术耳夹板或塑形,可以有效矫正多种先天性耳部畸形。早期开始非手术治疗耳部畸形的紧迫性使得及时识别这些耳部畸形变得至关重要,因为在年龄较大的婴儿和儿童中,手术矫正仍然是唯一可行的重建选择。

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