Leto Barone Angelo A, Farley Gabrielle, Vieira Alves Vinicius P, Bredemeier Nina O, Hogan Elise, Madzia Jules, Woodyard Kiersten, Schwentker Ann R, Fleck Robert J
From the Division of Plastic Surgery, Cincinnati Children's Hospital, Cincinnati, Ohio.
Division of Plastic Surgery, Nemours Children's Hospital, Orlando, Fla.
Plast Reconstr Surg Glob Open. 2023 Aug 16;11(8):e5210. doi: 10.1097/GOX.0000000000005210. eCollection 2023 Aug.
In patients with microtia, auricular reconstruction is ideally performed promptly to prevent impaired socialization during formative childhood years. The earliest viable age for reconstruction is widely accepted from 7-10 years of age, as full auricular size is achieved around age 8, with some variability dependent on sex. This retrospective study aims to provide an auricular growth curve that accounts for age and sex, enhancing the individualized approach to ear reconstruction.
A total of 319 images of unaffected patients who underwent computed tomography angiography of the head and neck were reviewed, with bilateral cartilage height and width measured according to a consensus-standardized image measurement protocol. Means and SDs of cartilage height and width were calculated for both sexes, and analysis of ear growth was performed through plotting the mean cartilage height, width, and width:height ratio over time.
Cartilage height and width differed significantly between male and female groups. Maximum cartilage height was reached at age 11 for female and at age 12 for male patients, whereas maximum cartilage width was reached at ages 10 and 8, respectively. On average, the width:height ratio for female group was 0.58. For male group, the average width:height ratio was 0.59.
An auricular growth map was designed using computed tomography measurements demonstrating maximum auricular size at age 11 and 12 respectively for female and male patients, with both sexes having a width:height ratio maintained at approximately 0.6 throughout growth.
对于小耳畸形患者,理想情况下应尽早进行耳廓重建,以防止在儿童成长阶段社交能力受到损害。耳廓重建的最早可行年龄普遍认为是7至10岁,因为在8岁左右可达到完整耳廓大小,不过存在一定个体差异,部分取决于性别。这项回顾性研究旨在提供一条考虑年龄和性别的耳廓生长曲线,以加强耳廓重建的个体化方法。
回顾了319例接受头颈部计算机断层血管造影的未受影响患者的图像,按照共识标准化图像测量方案测量双侧软骨的高度和宽度。计算了男女两性软骨高度和宽度的均值及标准差,并通过绘制平均软骨高度、宽度及宽度与高度之比随时间的变化情况来分析耳朵生长情况。
男女组之间软骨高度和宽度存在显著差异。女性患者在11岁时达到最大软骨高度,男性患者在12岁时达到最大软骨高度,而最大软骨宽度分别在10岁和8岁时达到。女性组的宽度与高度之比平均为0.58。男性组的平均宽度与高度之比为0.59。
利用计算机断层扫描测量设计了一张耳廓生长图,显示女性和男性患者分别在11岁和12岁时达到最大耳廓尺寸,且两性在整个生长过程中宽度与高度之比均维持在约0.6。