改良Brent法全耳再造术治疗先天性小耳畸形的临床分析
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湖南省儿童医院

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湖南省出生缺陷协同防治科技重大专项(课题编号2019SK1015)


Clinical analysis of modified Brent method for total ear reconstruction in the treatment of congenital microtia.
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1.Hunan Children'2.'3.s Hospital

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    目的:探讨改良Brent法全耳再造术治疗先天性小耳畸形的临床效果及经验。方法:选取2018年11月到2021年4月我院收治的用改良Brent法全耳再造术治疗先天性小耳畸形的患儿20例,20例均为单侧耳畸形,年龄6.5岁-15岁,平均年龄8.7岁。一期,首先处理残耳,分离耳后乳突区形成囊腔,同时行耳垂转位。取患耳对侧的肋软骨雕刻成耳廓支架,在传统雕刻的基础上,同时雕刻出耳屏,尽可能的加深耳舟和三角窝的深度,在修剪耳轮时,将耳轮脚的前端尽可能垫高,尖端留置的更长,以凸显耳轮脚的深度。将耳廓支架埋置于耳后囊腔内。二期,“立耳”,颅耳角成形。三期:耳甲腔成形。结果:20例再造耳一期手术出现血肿1例,二期手术出现感染1例,支架外露1例,通过局部处理均恢复,并继续进行下一期手术。20例患者三期期手术术后随访3-9个月,再造耳双耳对称性佳,耳轮脚、耳屏处形态佳,颅耳沟加深,耳垂与耳廓下部接合处的线条流畅,再造耳总体外观满意。结论:改良Brent法全耳再造术,可更凸显耳屏、耳轮脚、三角窝及耳垂等部位的细微结构,更能呈现出再造耳的立体感,该方法可为先天性小耳畸形手术方式的选择提供参考。

    Abstract:

    Objective To explore the clinical effect and experience of modified Brent method for total ear reconstruction in the treatment of congenital microtia. Methods A total of 20 children with congenital microtia treated by modified Brent method total ear reconstruction in our hospital from November 2018 to April 2021 were selected. 8.7 years old. In the first stage, the residual ear is first treated, the mastoid region behind the ear is separated to form a cyst, and the earlobe is transposed at the same time. Take the costal cartilage on the opposite side of the affected ear and carve it into the auricle bracket. On the basis of traditional carving, the tragus is carved at the same time to deepen the depth of the auricular navicular and triangular fossa as much as possible. Possibly elevated and the tip left longer to accentuate the depth of the helix. The auricle stent is embedded in the back of the ear cavity. The second phase, "Earling", the formation of the cranial ear angle. Stage 3: Concha cavity formation. Results: Among the 20 cases of ear reconstruction, 1 case had hematoma in the first-stage operation, 1 case had infection in the second-stage operation, and 1 case had stent exposure. All recovered after local treatment, and the next operation was continued. 20 patients were followed up for 3-9 months after the three-stage operation. The reconstructed ears showed good symmetry of both ears, good shape of the helix crus and tragus, deepened cranio-auricular grooves, and smooth transition between the earlobe and the lower part of the auricle. Satisfied with the overall appearance of the ear.conclusion The modified Brent method of total ear reconstruction can better highlight the fine structures of the tragus, helix crus, triangular fossa and earlobe, and can better present the three-dimensional sense of reconstructed ear. This method can provide reference for the selection of surgical methods for congenital microtia.

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  • 收稿日期:2022-02-24
  • 最后修改日期:2022-03-29
  • 录用日期:2022-04-11
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