无创耳廓矫形器干预先天性耳廓畸形的效果影响因素分析

Effect and influencing factors of noninvasive auricular orthosis for the treatment of congenital auricular malformation

摘要:

目的 通过评估无创耳廓矫形器在治疗先天性耳廓畸形儿童中的疗效，探讨矫正效果的影响因素。方法 选取2020年6月—2023年8月在黄石市妇幼保健院接受EarWell耳廓矫形器治疗的先天性耳廓畸形患儿353例(490耳)，根据开始治疗的日龄，患儿被分为3组：A组128例(202耳)≤7 d、B组123例(162耳)8～42 d和C组102例(126耳)43~90 d。比较3组患儿的临床疗效及并发症发生率。对患儿进行跟踪随访，根据患儿的预后效果将患儿分为预后良好组与预后不良组，通过Logistic回归分析探讨影响耳廓畸形患儿预后的影响因素。结果 A组患者的临床有效率高于B、C组(P＜0.05)；A组的不良反应发生率低于B、C组的不良反应发生率(P＜0.05)；随访结果显示283例患儿预后良好，70例患儿预后不良。两组患儿年龄、容貌耳长、耳廓畸形Max分型、外耳道闭锁分级比较差异具有统计学意义(P均＜0.05)；通过Logistic回归分析，结果显示，年龄与耳廓畸形Max分型是影响EarWell耳廓矫形器校正预后的因素。结论 矫形器治疗对先天性耳廓畸形具有显著的矫正效果。患儿年龄及耳廓畸形Max分型是影响预后的关键因素。

Abstract:

Objective To evaluate the effect of noninvasive auricular orthosis in the treatment of children with congenital auricular malformation, and to explore the influencing factors. Methods A total of 353 children (490 ears) with congenital auricular malformation who received EarWell auricular orthosis at Huangshi Maternal and Child Health Care Hospital from June 2020 to August 2023 were included in this study. According to the age of starting treatment, they were divided into three groups, Group A (≤7 days, 128 cases, 202 ears), group B (8-42 days, 123 cases, 162 ears), and group C (43-90 days, 102 cases, 126 ears). The clinical effect and complication rate among the three groups were compared. The children were followed up and divided into a good prognosis group and a poor prognosis group according to their prognosis. Logistic regression analysis was used to explore the factors affecting the prognosis of children with auricular malformation. Results The clinical effective rate of group A was higher than those of group B and group C (P<0.05). The incidence of adverse reactions in group A was lower than those in groups B and C (P<0.05). The results of follow-up revealed that 283 cases had good prognosis and 70 cases had poor prognosis. The differences in age, facial ear length, Max classification of auricle malformation and atresia grade between the two groups were statistically significant (all P<0.05). Logistic regression analysis showed that age and Max classification of auricular deformity were the factors affecting the prognosis of EarWell auricular orthosis correction.Conclusions Orthotic treatment has a remarkable effect on the correction of congenital auricular deformity. Age and Max type of auricular malformation are the key factors affecting prognosis.