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保留软骨的耳成形术——3 年内 288 只耳朵。

Cartilage-sparing otoplasty - 288 ears in 3 years.

机构信息

Kaplan Medical Center, Department of Plastic and Reconstructive Surgery, Rehovot, Israel.

Maccabi Healthcare Services, Tel Aviv, Israel; Dr. Benkler Plastic Surgery, Tel Aviv, Israel.

出版信息

J Plast Reconstr Aesthet Surg. 2024 Dec;99:209-220. doi: 10.1016/j.bjps.2024.09.031. Epub 2024 Sep 17.

Abstract

BACKGROUND

Standard methods of otoplasty may risk anatomical distortion. Previous work showcased a novel, cartilage-sparing technique. This study aimed to confirm the safety and effectiveness of the method in a larger cohort.

METHODS

This retrospective study included patients undergoing otoplasty by a single surgeon using a single technique between January 2021 and December 2023. Eligible patients were aged >5 years and had prominent or constricted or cup ears, forming a 2 cm distance from the mastoid. Surgical techniques included novel key-point sutures. Minimum follow-up was 6 months. Data on demographics, risk factors, perioperative management, and complications were collected from patient records.

RESULTS

A total of 288 operated ears (147 patients) were included. The mean age was 17 years, and 91 (61.9%) were female. The mean duration of follow-up was 24.3 months. Postoperative complications were generally minor and included Polydioxanone (PDS) suture exposure (n = 16, 5.5%), manageable postoperative pain (n = 8, 2.7%), self-resolving swelling (n = 8, 2.7%), minor bleeding (n = 7, 2.4%), and superficial skin complications (n = 4, 1.3%). Infections occurred in 4 ears (1.3%) and were treated effectively with topical/oral antibiotics. Cases of partial release of the ear resolved without intervention (n = 4, 1.3%). Only 4 (1.3%) ears experienced loss of correction, with options for reoperation available as needed. Analysis showed no significant age differences in postoperative complications and a nonsignificant trend towards higher postoperative swelling in males than in females (10.7% vs 2.2%; P = 0.054).

CONCLUSIONS

The data confirms that this technique offers safe and rapid cartilage-sparing otoplasty with minimal complications and low recurrence rates. It ensures long-lasting and aesthetically pleasing results for prominent ear deformities.

LEVEL OF EVIDENCE

Level III.

摘要

背景

标准的耳部整形方法可能存在解剖结构变形的风险。先前的工作展示了一种新颖的、保留软骨的技术。本研究旨在更大的队列中确认该方法的安全性和有效性。

方法

本回顾性研究纳入了 2021 年 1 月至 2023 年 12 月间由同一位外科医生采用单一技术进行耳部整形的患者。符合条件的患者年龄>5 岁,存在明显或狭窄或杯状耳畸形,与乳突之间的距离形成 2 厘米。手术技术包括新颖的关键点缝合。从患者病历中收集人口统计学、危险因素、围手术期管理和并发症的数据。

结果

共纳入 288 只手术耳(147 例患者)。平均年龄为 17 岁,91 例(61.9%)为女性。平均随访时间为 24.3 个月。术后并发症一般较轻,包括聚二氧杂环已酮(PDS)缝线外露(16 例,5.5%)、可管理的术后疼痛(8 例,2.7%)、自限性肿胀(8 例,2.7%)、轻微出血(7 例,2.4%)和浅表皮肤并发症(4 例,1.3%)。4 只耳(1.3%)发生感染,经局部/口服抗生素治疗有效。4 例(1.3%)部分耳松解病例无需干预即可自行解决。仅 4 只耳(1.3%)出现矫正丢失,可根据需要选择再次手术。分析显示,术后并发症与年龄无显著差异,男性术后肿胀程度高于女性,但无统计学意义(10.7%比 2.2%;P=0.054)。

结论

数据证实,该技术可安全、快速地进行保留软骨的耳部整形,并发症少,复发率低。它确保了显著耳畸形的持久和美观的效果。

证据水平

III 级。

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