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改良的 Valente 技术治疗菜花耳:两年随访的结果:一种新的菜花耳手术技术。

Modified Valente Technique for Cauliflower Ear: Outcomes in Children at Two-Year Follow-Up : New Surgical Technique for Cauliflower Ear.

机构信息

Department of Otolaryngology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro-Fano, Italy.

Department of Otolaryngology, University of Perugia, Perugia, Italy.

出版信息

Aesthetic Plast Surg. 2024 May;48(10):1906-1913. doi: 10.1007/s00266-024-03914-5. Epub 2024 Mar 18.

Abstract

BACKGROUND

Cauliflower ear deformity, a common sequela of auricular trauma, presents an esthetic and reconstructive challenge. Existing surgical techniques have limitations, including complexity, donor site morbidity, and variable long-term outcomes.

MATERIALS AND METHODS

In this case series, we present a novel and minimally invasive surgical approach for the correction of cauliflower ear deformity that adapts the Valente otoplasty technique; it combines cartilage debulking with helical rim release and Mustardé mattress stitches to restore ear contour and reduce the risk of recurrence. The procedural steps include bielliptic post-auricular skin and soft tissue incision, release of the cartilaginous spring, removal of excess fibrocartilaginous tissue, cartilage reshaping with suture to restore contour, and tissue redistribution to promote adherence of skin to the cartilage framework.

RESULTS

Outcomes were evaluated in 7 patients (9 ears) with cauliflower ear deformity, assessing surgical duration, complications, patient satisfaction, and esthetic outcomes at two years after surgery. The mean surgical duration per patient was 52 ± 17 minutes, including 2 bilateral procedures. Follow-up at 24 months showed favorable esthetic outcome in all patients with sustained improvements in auricular contour and symmetry with neither loss of the shape nor recurrence of deformity. Patients reported high satisfaction and improved quality of life, with mean Glasgow Children Benefit Questionnaire scores of 99.3 ± 6.3.

CONCLUSIONS

This technique thus demonstrated lasting correction of cauliflower ear with favorable cosmetic outcomes, low risk of complications, and high patient satisfaction. Further investigations and longer-term follow-up are warranted to validate the technique's durability and expand its application to older and more diverse patient populations.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

菜花耳畸形是耳部创伤的常见后遗症,给患者带来美观和重建方面的挑战。现有的手术技术存在局限性,包括手术复杂性、供区并发症和术后长期效果的不确定性。

材料与方法

本病例系列报告了一种新颖的微创外科方法,用于矫正菜花耳畸形。该方法改编自 Valente 耳成形术技术,结合软骨消蚀术、耳轮缘松解术和 Mustardé 褥式缝合术,以恢复耳廓轮廓并降低复发风险。手术步骤包括耳后双椭圆形皮肤和软组织切口、松解软骨弹簧、去除多余的纤维软骨组织、缝合软骨重塑以恢复轮廓,以及组织重新分布以促进皮肤与软骨框架的贴合。

结果

对 7 例(9 耳)菜花耳畸形患者的手术结果进行了评估,评估指标包括手术时间、并发症、患者满意度和术后两年的美学效果。每位患者的平均手术时间为 52±17 分钟,其中包括 2 例双侧手术。术后 24 个月随访显示所有患者的美学效果均良好,耳廓轮廓和对称性持续改善,无形状丢失或畸形复发。患者报告满意度高,生活质量改善,平均格拉斯哥儿童福利问卷评分(Glasgow Children Benefit Questionnaire score)为 99.3±6.3。

结论

该技术能够持久矫正菜花耳畸形,美学效果良好,并发症风险低,患者满意度高。需要进一步的研究和长期随访,以验证该技术的持久性,并扩大其在年龄更大、更广泛患者群体中的应用。

证据等级 IV:本杂志要求作者为每篇文章分配一个证据等级。如需了解这些循证医学分级的详细信息,请参考目录或在线作者指南(www.springer.com/00266)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75d4/11133056/f6fa454817f5/266_2024_3914_Fig1_HTML.jpg

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