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一种新的 Tanzer ⅡB 型束状耳矫正方法:使用 V-Y 推进皮瓣联合耳甲软骨移植的螺旋扩张法。

A new corrective method for the Tanzer's group IIB constricted ear: Helical expansion using V-Y advancement flap combined with concha cartilage graft.

机构信息

Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

J Plast Reconstr Aesthet Surg. 2024 Oct;97:59-64. doi: 10.1016/j.bjps.2024.07.070. Epub 2024 Aug 5.

Abstract

BACKGROUND

The complexity of a constricted ear shape renders the aim of establishing a uniform surgical method unattainable, thus posing an ongoing challenge in its correction. The Tanzer's group IIB constricted ear is characterized by a prominent downward folding, an underdeveloped antihelix, and the absence of sacpha. The present study used a V-Y advancement flap combined with concha cartilage for the repair of Tanzer's group IIB constricted ear.

METHOD

A total of 16 patients diagnosed with type IIB ear constriction from September 2016 to September 2022 were enrolled in this retrospective study. The correction procedure for the constricted ear involved the utilization of a V-Y advancement flap combined with concha cartilage graft. The auricle shape data of the patients, their visual analog scale (VAS) satisfaction scores, and aesthetic outcomes scale (AOS) aesthetic scores were examined preoperatively and 12 months post-operatively.

RESULT

The mean duration of follow-up in this study was 18 months. The post-operative measurements of ear length, ear width, bilateral differences in ear length, and bilateral differences in ear width exhibited significant improvement compared to the preoperative values. The mean preoperative AOS score was 1.12 ± 0.34, and the mean post-operative AOS score increased to 3.81 ± 0.40. The preoperative VAS satisfaction score was 2.31 ± 0.70, whereas the post-operative VAS score significantly increased to 8.00 ± 0.89. The follow-up period did not present any cases of flap necrosis, hematoma, infection, or wound dehiscence.

CONCLUSION

The combination of V-Y advancement flap and concha cartilage transplantation for the correction of Tanzer's group IIB constricted ear can achieve a natural and aesthetically pleasing auricle shape, resulting in high patient satisfaction.

摘要

背景

形态复杂的招风耳,其手术方法难以统一,矫正效果也不理想,一直是耳畸形矫正的难点。Tanzer ⅡB 型招风耳的特点是耳轮向下卷曲,耳舟发育不良,耳甲腔消失。本研究采用 V-Y 推进皮瓣联合耳甲腔软骨矫正 Tanzer ⅡB 型招风耳。

方法

回顾性分析 2016 年 9 月至 2022 年 9 月收治的 16 例 Tanzer ⅡB 型招风耳患者,采用 V-Y 推进皮瓣联合耳甲腔软骨矫正,比较术前、术后 12 个月患者的耳廓形态数据、疼痛视觉模拟评分(VAS)、美容效果评价量表(AOS)评分。

结果

本研究平均随访 18 个月。术后患者耳长、耳宽、双侧耳长差值、双侧耳宽差值均较术前明显增加。术前 AOS 评分为 1.12±0.34,术后增加至 3.81±0.40;术前 VAS 评分为 2.31±0.70,术后增加至 8.00±0.89。随访期间无皮瓣坏死、血肿、感染及切口裂开等并发症。

结论

V-Y 推进皮瓣联合耳甲腔软骨移植矫正 Tanzer ⅡB 型招风耳可获得较自然、美观的耳廓形态,患者满意度高。

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