Department of Plastic and Reconstructive Surgery, the First Hospital of Jilin University, Changchun, Jilin, China.
J Craniofac Surg. 2024;35(1):e18-e21. doi: 10.1097/SCS.0000000000009665. Epub 2023 Aug 28.
Postoperative recovery from severe auricular lacerations varies significantly. However, few studies have sought to clarify the risk factors associated with the prognosis of severe auricular lacerations, and little attention has been paid to the intraoperative management of severe auricular lacerations and early postoperative intervention. The purpose of this study was to analyze the risk factors that may affect the prognosis of severe auricular lacerations.
Case data and imaging data of patients with severe auricular lacerations treated in our department between January 2018 and September 2022 were collected. A total of 90 patients (90 severe auricular lacerations) were included in the analysis and were divided into good group (68 cases) and poor group (22 cases) according to postoperative recovery, which was defined as poor postoperative recovery when postoperative auricular blood supply disorders required interventional treatment or second stage plastic surgery.
The percentage of ventral tissue pedicles in the poor recovery group was 77.3% ( P <0.001). The proportion of ventral tissue pedicle was significantly higher in the poor postoperative group than in the good postoperative group, and ventral tissue pedicle [odds ratio (OR)=12.22, P =0.002] was an independent risk factor for poor postoperative recovery from severe auricular laceration.
The prognosis of patients with severe auricular lacerations differs between the different tissue pedicle locations, and prophylactic treatment of patients with ventral tissue pedicles is beneficial. In addition, patients with ventral tissue pedicles should be informed in advance of their increased risk of surgical failure.
严重耳廓撕裂伤的术后恢复差异很大。然而，很少有研究试图阐明与严重耳廓撕裂伤预后相关的风险因素，并且对内耳严重撕裂伤的术中处理和早期术后干预关注甚少。本研究旨在分析可能影响严重耳廓撕裂伤预后的风险因素。
收集 2018 年 1 月至 2022 年 9 月我科收治的严重耳廓撕裂伤患者的病例资料和影像学资料。共纳入 90 例（90 例严重耳廓撕裂伤）患者，根据术后恢复情况分为预后良好组（68 例）和预后不良组（22 例），术后耳廓血供障碍需要介入治疗或二期整形手术定义为预后不良。
预后不良组腹侧组织蒂的百分比为 77.3%（P<0.001）。预后不良组腹侧组织蒂的比例明显高于预后良好组，腹侧组织蒂[比值比（OR）=12.22，P=0.002]是严重耳廓撕裂伤术后恢复不良的独立危险因素。
不同组织蒂位置的患者严重耳廓撕裂伤的预后不同，对腹侧组织蒂患者进行预防性治疗是有益的。此外，应提前告知腹侧组织蒂患者手术失败风险增加。
