人造耳支架植入在先天性小耳畸形中的应用——18年临床经验总结

Application of Medpor porous polyethylene ear framework in auricular reconstruction of microtia: An 18-year experience

摘要:

目的 观察并探讨高分子聚乙烯人造耳支架植入行全耳廓再造术的临床效果与经验。方法 收集2003年5月—2021年6月诊治的小耳畸形患者1 057例(1 063耳)，分别对其手术方式、手术成功率、耳廓的对称度、耳廓精细结构显示、患者的满意度、并发症发生情况及听力恢复情况进行评估。结果 术后随访6个月至16年。1 063耳手术均成功，耳廓形态随着时间的延长而逐渐显露。对耳廓的7个对称度指标进行评分，均在5分以上;对耳廓的14个精细结构进行评分，945耳(88.90%)≥10分。患者的总满意率为92.00%(978/1 063耳)。同期行听力重建的患者术后得到不同程度的听力改善。结论 先天性小耳畸形高密度聚乙烯人造耳支架植入全耳廓再造术在临床上安全可行，可以作为耳再造的方法之一;并可以同期行听力重建术，在再造耳廓的同时取得较好的听力康复效果，也可以使再造耳廓在形态上更加逼真，提高患者的满意率。

关键词:小耳畸形;高分子聚乙烯支架;耳再造

Abstract:

Objective To observe and evaluate the clinical effect of and experience in total auricular reconstruction with Medpor polymer polyethylene artificial ear framework implantation. Methods A total of 1 057 patients (1 063 ears) with microtia accepted auricular reconstruction from May 2003 to June 2021 in our department were included. The surgical methods and success rate, scores of symmetry and fine structures of the auricle, patient satisfaction, surgical complications together with hearing improvement were evaluated. Results All patients had been followed up for 6 months to 16 years postoperatively, successful reconstruction of all the 1 063 ears was achieved, and the auricle shape recovered well gradually. Scores of seven auricle symmetrical indexes were all more than 5. The proportion of the score of 14 fine structures in the auricle more than 10 was 88.90% (945/1 063). The overall satisfaction rate of patients was 92.00% (978/1 063). Patients undergoing simultaneous hearing reconstruction obtained varying degrees of hearing improvement. Conclusions Medpor implantation is clinically safe and feasible for the treatment of the congenital microtia, which can be used as one method of auricular reconstruction. Besides, simultaneous hearing reconstruction can be performed, which not only makes the reconstructed auricle more realistic, but improves the patient's satisfaction rate.

Key words:Congenital microtia;Medpor polymer polyethylene framework;Auricular reconstruction