先天性小耳畸形的功能性再造进展与挑战  

Functional reconstruction surgery of congenital microtia/atresia

作　　者：张天宇 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼耳鼻整形外科卫生部听觉医学重点实验室耳鼻喉科研究院,上海200031

出　　处：《中国眼耳鼻喉科杂志》2018年第1期7-10,14,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：国家自然科学基金面上项目(81771014;81570934)

摘　　要：先天性小耳畸形是头面部常见畸形之一,发生机制和致病原因尚不明确。全耳廓再造和听力重建手术是目前主要的解决手段。耳廓再造技术经历了"大饼耳""浮雕耳""自然耳"阶段逐步完善;听觉重建手术在合并有外耳道狭窄的小耳畸形患者,三期联合功能再造手术效果良好。植入式振动助听技术对难以手术重建听觉的患者,听觉康复效果稳定。"美学与功能"耳再造的技术方案与适应证逐渐明确。但任何外科手术技术都有局限性,先天性小耳畸形的功能性再造仍是一个充满挑战性的问题。本文就耳外科和整形外科医师密切合作,在美学与功能性耳再造方向的技术进展和探索进行分析和展望。Congenital microtia/atresia is one of the common deformities in the head and face. The pathogenesis and etiology of the disease are unclear. The main treatments include total auricular reconstruction and hearing restoration surgery. Auricle reconstruction technology has developed from ＂shaped ear＂ and ＂contours ear＂ to ＂ natural ear＂. The hearing restoration surgery was used in external auditory canal stenosis and microtia. The outcomes for patients with three stage combined reconstruction surgery were better. The effect of implantable vibration hearing aid was stable in the patients difficult to reconstruct the heating. The operation procedures and the indications of ＂aesthetic and functional＂ ear reconstruction have been gradually definitely decided. However, every surgical technique has limitations, and the functional reconstruction for congenital microtia/atresia is still one of the greatest challenges in reconstructive surgery. Thisarticle will prospect the direction and development of aesthetic and functional ear reconstruction from the cooperation of the otologists and plastic surgeons.

关 键 词：先天性小耳畸形 全耳廓再造 听力重建 功能性再造手术 耳外科手术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]