Hazkour Nissim, Goote Paige, Palacios Jose, Gottfried Jennifer, Kang Inkyu, Bastidas Nicholas
SUNY Downstate College of Medicine, Brooklyn.
Division of Plastic and Reconstructive Surgery, Northwell Health, Great Neck.
J Craniofac Surg. 2023;34(1):258-261. doi: 10.1097/SCS.0000000000008866. Epub 2022 Aug 9.
Many parents seek otoplasty for their school age children but fear having to undergo general anesthesia (GA). In our experience, otoplasty can safely be performed in an office-based setting under local anesthesia (LA). There is a gap in the literature regarding pediatric otoplasty under LA.
All children aged 5 to 10 who underwent otoplasty between 2017 and 2021 were included in a retrospective review. Demographics, operative techniques, complications, recurrences, and reoperation rates were collected. Surveys were provided 3 months after treatment to assess parental satisfaction and anxiety. Results were compared between patients who received otoplasty under GA and LA.
A total of 13 patients (6 male, 7 female), with a mean age of 7 years (ranging 5-10) underwent otoplasty under LA. Tweleve children (6 male, 6 female), with a mean age of 5 years (ranging 4-7) underwent otoplasty under GA. The only complications seen were 3 minor conchal bowl hematomas that were aspirated, each retrieving <1 mL of blood; no revisions were necessary. The LA subgroup was more likely to repeat otoplasty under identical conditions ( P =0.025). Postoperatively, mean parental anxiety scores between the LA and GA subgroups were significantly different (1.4±1.1 versus 4.8±2.7, P =0.0005). Lastly, the mean satisfaction scores between the LA and GA subgroups were marginally different (3.83±0.58 versus 3.17±1.03, P =0.063).
Pediatric otoplasty under LA is a safe and feasible operation for patients between 5 and 10 years of age.
许多家长为学龄期孩子寻求耳部整形手术,但又担心必须接受全身麻醉(GA)。根据我们的经验,耳部整形手术可以在门诊环境下在局部麻醉(LA)下安全进行。关于局部麻醉下小儿耳部整形手术的文献存在空白。
对2017年至2021年间接受耳部整形手术的所有5至10岁儿童进行回顾性研究。收集人口统计学、手术技术、并发症、复发情况和再次手术率。在治疗后3个月进行调查,以评估家长的满意度和焦虑程度。比较接受全身麻醉和局部麻醉下耳部整形手术的患者结果。
共有13例患者(6例男性,7例女性),平均年龄7岁(5至10岁),在局部麻醉下接受了耳部整形手术。12例儿童(6例男性,6例女性),平均年龄5岁(4至7岁),在全身麻醉下接受了耳部整形手术。仅出现3例轻微的耳甲腔血肿,均通过抽吸处理,每次抽出的血液<1毫升;无需进行修复手术。局部麻醉组在相同条件下更有可能再次进行耳部整形手术(P = 0.025)。术后,局部麻醉组和全身麻醉组家长的平均焦虑评分有显著差异(1.4±1.1对4.8±2.7,P = 0.0005)。最后,局部麻醉组和全身麻醉组的平均满意度评分略有差异(3.83±0.58对3.17±1.03,P = 0.063)。
对于5至10岁的患者,局部麻醉下小儿耳部整形手术是一种安全可行的手术。