McGarry Kevin M, Khadim Muhammad F, McBride Michael, Martin Serena, Moorehead Andrew, Rashid Abid, Hill Chris, Fogarty Brendan
From the Department of Plastic Surgery, Royal Belfast Hospital for Sick Children.
Plast Reconstr Surg. 2023 Mar 1;151(3):388e-397e. doi: 10.1097/PRS.0000000000009908. Epub 2022 Nov 19.
"Prominent ear" remains one of the most common referrals to pediatric plastic surgery. The perceived deformity has been corrected using a multitude of techniques for over a century, and significant variation in practice still exists. Recent studies suggesting that cartilage-scoring techniques are associated with more major complications than suture techniques may have led to an adverse international perception of the technique. Thus, waning use of anterior scoring prominent ear correction appears to be occurring. For appropriate cases, the authors have used anterior scoring for over 20 years, with high patient satisfaction and low complication rates. They present a review of all cases and outcomes from 2005 to 2015. The authors believe this is the largest case series of anterior scoring otoplasty published to date.
All pediatric cases undergoing prominent ear correction from 2005 to 2015 were included in this retrospective case note analysis and follow-up study. Patient demographics, operative details including early and late complications, and postoperative results were analyzed.
Over a 10-year period, 1199 otoplasties were performed (1134 bilateral, 65 unilateral), for a total of 2333 ear corrections. A total of 1575 ears were corrected using the anterior scoring technique. The remaining cases underwent correction by means of suture only, cartilage reduction, or combination techniques. There was a significantly lower all-cause reoperation rate for anterior scoring compared to suture-only techniques ( P = 0.0039; significant at P < 0.025). There were no reported cases of cartilage necrosis.
This study demonstrates that in appropriately selected patients, anterior scoring otoplasty is a low-morbidity procedure. In the authors' institution, when compared to suture techniques, it was associated with a lower rate of complications and reoperation rate than suture-only techniques.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
“招风耳”仍是小儿整形外科最常见的转诊病例之一。一个多世纪以来，人们运用了多种技术来矫正这种明显的畸形，目前在实际操作中仍存在显著差异。最近的研究表明，软骨划痕技术比缝合技术会引发更多严重并发症，这可能导致了国际上对该技术的负面看法。因此，采用耳前划痕法矫正招风耳的情况似乎越来越少。在合适的病例中，作者运用耳前划痕法已有20多年，患者满意度高，并发症发生率低。他们对2005年至2015年期间的所有病例及结果进行了回顾。作者认为这是迄今为止发表的关于耳前划痕法耳成形术的最大病例系列。
本回顾性病例记录分析及随访研究纳入了2005年至2015年期间所有接受招风耳矫正的小儿病例。分析了患者的人口统计学数据、早期和晚期并发症以及术后结果。
在10年期间，共进行了1199例耳成形术（1134例双侧，65例单侧），共计2333只耳朵得到矫正。其中1575只耳朵采用耳前划痕技术进行矫正。其余病例采用单纯缝合、软骨缩减或联合技术进行矫正。与单纯缝合技术相比，耳前划痕法的全因再次手术率显著更低（P = 0.0039；P < 0.025时有统计学意义）。未报告软骨坏死病例。
本研究表明，在适当选择的患者中，耳前划痕法耳成形术是一种发病率低的手术。在作者所在机构，与缝合技术相比，它的并发症发生率和再次手术率低于单纯缝合技术。
临床问题/证据级别：治疗性，IV级。
