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应用改良注水法及保留残耳无植皮的改良全耳郭再造技术的临床疗效

Clinical efficacy of modified total auricular reconstruction technique by using reformative inflation method and remnant ear without skin grafting.

作者信息

Zhang Yingyi, Liu Chuanqi, Wei Shiyou, Zhu Guonian, Li Zhengyong

机构信息

Department of Plastic Surgery and Burns, West China Hospital, Sichuan University, Chengdu, China.

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Ann Transl Med. 2021 May;9(10):890. doi: 10.21037/atm-21-1302.

Abstract

BACKGROUND

As one of the most widely used methods to treat microtia, the auricular reconstruction proposed by Zhuang may have several drawbacks. This study aimed to introduce a modified Zhuang's ear reconstruction technique by using a reformative inflation method and remnant ear to shorten therapy time and avoid skin grafting in a two-stage operation for patients with microtia.

METHODS

A total of 124 patients with microtia were enrolled consecutively from 2014 to 2018. Among them, 66 patients underwent a modified Zhuang's method, and the remaining patients underwent Zhuang's method. The clinical and perioperative characteristics of patients, as well as complications and esthetic outcomes were analyzed.

RESULTS

Compared with Zhuang's group, our modified Zhuang's group had better average esthetic scores according to two plastic surgeons [11.5 (IQR, 10.5-12.5) 9.5 (IQR, 7.5-11.0), P<0.001], fewer hypertrophic scar cases [0% (n=0/66) 10% (n=6/58), P = 0.024], shorter whole therapy duration [2.5 (IQR, 2.4-2.6) 5.0 (IQR, 5.0-5.1) days, P<0.001] and shorter hospital duration after operation [5 (IQR, 5-6) 6 (IQR, 5-6) days, P=0.013].

CONCLUSIONS

Our modified Zhuang's technique is a new method to treat microtia which results in a clear contour of the reconstructed ear and matching skin color, minimal scarring, and a short treatment time.

摘要

背景

作为治疗小耳畸形最广泛使用的方法之一,庄氏耳再造术可能存在一些缺点。本研究旨在介绍一种改良的庄氏耳再造技术,通过采用改良的扩张方法和利用残余耳,以缩短治疗时间,并避免在小耳畸形患者的两期手术中进行植皮。

方法

2014年至2018年连续纳入124例小耳畸形患者。其中,66例患者接受改良庄氏法,其余患者接受庄氏法。分析患者的临床和围手术期特征,以及并发症和美学效果。

结果

与庄氏组相比,我们的改良庄氏组根据两位整形外科医生的评估,平均美学评分更高[11.5(四分位间距,10.5 - 12.5)对9.5(四分位间距,7.5 - 11.0),P<0.001],增生性瘢痕病例更少[0%(n = 0/66)对10%(n = 6/58),P = 0.024],总治疗时间更短[2.5(四分位间距,2.4 - 2.6)对5.0(四分位间距,5.0 - 5.1)天,P<0.001],术后住院时间更短[5(四分位间距,5 - 6)对6(四分位间距,5 - 6)天,P = 0.013]。

结论

我们改良的庄氏技术是一种治疗小耳畸形的新方法,可使再造耳轮廓清晰、肤色匹配、瘢痕最小化且治疗时间短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00a8/8184466/83621e2b67f6/atm-09-10-890-f1.jpg

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