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
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上海交通大学医学院附属第九人民医院

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九院临床研究助力计划(JYLJ028):Clinical Research Program of 9th people's hospital, Shanghai Jiao Tong university school of medicine ;上海申康医院发展中心临床创新三年行动计划(16CR3119B):Clinical Research Plan of SHDC


Application of Medpor porous polyethylene ear framework in auricular reconstruction of microtias: A 18-year experience
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Shanghai ninth people’s Hospital, Shanghai Jiao Tong University School of Medicine

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    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月就诊于上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科(包含奉城分院)的小耳畸形患者1057例(1063耳),分别对手术方式、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月至16年余。1063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,88.90%(945/1063耳)≥10分。患者的总满意率为92.00%(978/1063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Medpor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。

    Abstract:

    Objective To observe and evaluate the clinical effect and experience of total auricular reconstruction with polymer polyethylene artificial ear framework implantation. Methods A total of 1057 patients with microtia accepted auricular reconstruction surgery from May 2003 to June 2021 at the Department of Otorhinolaryngology Head and Neck Surgery of the Ninth People Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (including Fengcheng Branch) were collected, different surgical methods, surgical success rate, scores of symmetry of the auricle and fine structure of the auricle, patient satisfaction, surgical complications together with hearing improvement were evaluated respectively. Results Postoperative follow-up for more than 6 to 16 years. All reconstructive operations were successful, and the pinna shape gradually became apparent over time. Score the seven symmetry indexes of the pinna after operation, each of which is more than 5 points; The 14 delicate structures of auricle were evaluated, and the proportion of more than 10 points was 88.90% (945 / 1063 ears). The overall satisfaction rate of patients was 92.00% (978/1063 ears). Patients undergoing hearing reconstruction at the same time received varying degrees of postoperative hearing improvement. Conclusion Medpor implantation of congenital microtia is clinically safe and feasible, which can be used as one of the methods of auricular reconstruction. Besides, hearing reconstruction surgery can be performed simultaneously, which not only making the reconstructed pinna more realistic, but improving the patient"s satisfaction rate.

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  • 收稿日期:2022-02-26
  • 最后修改日期:2022-04-20
  • 录用日期:2022-05-06
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