先天性耳廓畸形的早期非手术治疗  

Early non-surgical treatment of congenital auricular deformity

作　　者：林琳 蒋海越 杨庆华 何乐人 潘博 于晓波 周佳宇 Lin Lin;Jiang Haiyue;Yang Qinghua;He Leren;Pan Bo;Yu Xiaobo;Zhou Jiayu(Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院七科,北京100144

出　　处：《中华整形外科杂志》2018年第3期197-201,共5页Chinese Journal of Plastic Surgery

基　　金：北京市科学技术委员会资助（Z161100000516098、Z151100004015185-017）,协和青年基金、中央高校基本科研业务费专项资金资助（33320140171）,中国医学科学院医学与健康科技创新工程（c1FMS2016-12M-2-006）资助,整形医院优秀青年接力项目（2014）

摘　　要：目的探讨外置耳廓畸形矫正器矫正先天性耳廓畸形的临床效果。方法应用外置耳廓畸形矫正器对先天性耳廓畸形进行非手术治疗。按佩戴起始年龄（〈1月龄，1～3月龄，3～6月龄）分为3组，治疗后定期随访，根据耳廓形态改善情况分为正常（e），接近正常（g），有改善但不正常（f）及无改善（P）4级，并根据e和g的比例计算有效率。结果自2014年1月至2016年12月，应用外置耳廓畸形矫正器治疗并参加随访的6月龄内的先天性耳畸形患儿共140耳，其中耳轮畸形33耳、杯状耳29耳、招风耳12耳、Stahl’s耳4耳、隐耳62耳。本组隐耳、耳轮畸形、招风耳、轻中度杯耳、Stahl’S耳的治疗后3个月的治疗有效率（〈1月龄、1～3月龄、3～6月龄）分别为（100％、100％、87．5％），（100％、90．47％、66．67％），（一、100％、50％），（100％、78．57％、53．33％），（一、100％、33．33％），最长随访时间1．5年，未见复发。结论先天性耳廓畸形通过佩戴耳畸形矫正器行非手术治疗，年龄越小效果越好，需尽早佩戴，隐耳的患儿只要能配合年龄稍大效果也很好。该方法无创、易佩戴，效果良好，早期适当的治疗可尽量避免日后的手术，有助于节省社会医疗资源。Objective To investigate the effect of auricle deformity corrector in non-surgical treatment of congenital auricular deformity. Methods The auricular deformity correctors were applied for non-surgical treatment of congenital auricular deformities. The patients were divided into three groups according to the treatment starting age （ 〈 1 month old, 1 -3 months old, 3 -6 months old） , followed up for every month respectively after treatment. According to the improvement of auricle morphology, the treatment results were divided into four levels （e,g,f,p） and the effective rate （e ＋ g）% was calculated. Results From January 2014 to December 2016, there were 140 ears of congenital malformations in children aged less than 6 months who were treated and followed up. Among them, 33 ears had helical rim abnormalities, 29 with cup-shaped ears, 12 with prominent ears, 4 with Stahl＇s ears, and 62 with cryptotia ears. The therapeutic efficacies （ 〈 1 month old, 1 - 3 months old, 3 - 6 months） of these ear malformations were： cryptotia ear （100% , 100% , 87.5% ） , helical rim abnormality （100% , 90.47% , 66.67 % ） , prominent ear （ - , 100% , 50% ） , cup ear （100% ,78.57% , 53.33% ） , Stahl＇s ear （ - , 100% , 33.33% ）. Follow-up more than 6 months after treatment, up to a year and a half, no recurrence was found. Conclusions The auricular deformity corrector can be used as an effective approach for achieving natural outcomes and correcting cosmetic abnormalities. Rate of satisfaction is dependent on types of deformity, the neonatal age in which treatment started and also parents＇ compliance to treatment methods and principals. The method is noninvasive, easy to wear and works well. Early proper treatment can avoid future operations and save social medical resources.

关 键 词：耳廓 先天畸形 矫治 无创技术 

分 类 号：R764.71[医药卫生—耳鼻咽喉科]