应用软骨柱法矫治招风耳畸形的力学原理分析及临床研究  

The Mechanics Principle and Clinical Research of Ear Cartilage Column Method in Treating Prominent Ears

作　　者：钟奕 李铭[1] 郭志辉[1] 陈小松[1] 杨育成[1] 林静 ZHONG Yi;LI Ming;GUO Zhi-hui;CHEN Xiao-song;YANG Yu-cheng;LIN Jing(Department of Plastic Surgery and Regenerative Medicine,Fujian Medical University Union Hospital,Fujian Province,350001,China)

机构地区：[1]福建医科大学附属协和医院整形外科与再生医学科,福建福州350001

出　　处：《中国医疗美容》2022年第5期29-34,共6页China Medical Cosmetology

摘　　要：目的探索以软骨柱法矫治招风耳,并观察软骨柱法矫治招风耳畸形的临床效果,分析软骨柱法矫治招风耳畸形的力学原理。方法回顾性研究我院2015年1月-2019年12月年收治的15例25只招风耳,常规定点后,取梭形切口,沿耳后切口线切开皮肤及皮下组织,骨膜下分离两侧组织,完全暴露术区耳廓软骨,沿标记点在耳软骨表面作两道纵向切口,均至耳廓前面皮下,并在软骨表面作多条前窄后宽楔形截骨。将拟形成对耳轮轮廓的软骨向后卷曲对合形成软骨管。自耳前切取一段柱状耳甲腔耳软骨,长度与软骨管相当,埋置于软骨管中空处,将软骨管与移植耳软骨水平褥式缝合固定,逐个打结以获得外形自然的对耳轮。调节耳廓与头颅侧壁角度,约成30°。彻底止血后间断缝合皮肤切口。术后随访是否有出血、感染、术区皮肤坏死等并发症,并测量耳廓上端到颅骨的距离、颅耳角和耳舟耳甲的角度,应用SPSS18.0软件分析术前及术后数据,计量资料以均数±标准差表示,组间比较采用t检验,P<0.05为差异有统计学意义。并调查患者满意度及第三方满意度。结果接受手术的15例25只耳,耳廓与头颅、耳甲与耳舟形成的角相应得到缩小,塑形自然美观,均获得良好外形。随访6个月,无1例复发。患方、医务人员、第三方人士对术后耳廓形态、对称性及切口瘢痕均有较高的满意度。结论本文在软骨管法基础上进行改进,采取多条楔形软骨切除均匀释放软骨管张力,并对中空的软骨管置入软骨条形成软骨柱,形态稳固,线条流畅,患者满意度高,是一个行之有效的方法。Objective To observe the clinical efficacy and to analyze the mechanics principle of ear cartilage column method in treating prominent ear.Methods From January 2015 to December 2019,25 prominent ears of 15 patients were treated in our hospital with the ear cartilage column method.After routine fixation,we design a fusiform incision behind the ear,cut the skin and subcutaneous tissue along the incision line,and then separated the periosteum tissue.When completely exposed the auricular cartilage in the operation area,we made two longitudinal incisions on the surface of the ear cartilage along the marking point to the front of the auricle,then made 4-5 times of wedge-shaped osteotomy between the cartilage incision and were careful not to cut the anterior perichondrium and auricular skin of the auricular cartilage.The cartilage that was intended to shape the contour of the helix was crimped back to form a cartilage tube.Next,a columnar ear auricular cartilage with the same length of the cartilage tube was taken,and was buried in the hollow of the cartilage tube.Knotting one by one to obtain a natural shape of the helix and to adjust the auricular cranial horn to about 30°.Be cautious that there should be maintain enough margin width when suturing to prevent tearing of the cartilage.Finally suture the skin incision and stitch the auricle with a sterile gauze and elastic bandage.Complications such as hemorrhage,infection and skin necrosis in the operation area were observed carefully in one month after operation.After 6 months of operation,the distance from the upper part of the auricle to the skull,auricular cranial horn,and the angle of the ear canal were measured and analyzed with SPSS18.0 software.At the same time,the patients’and the bystanders’satisfaction were investigated.The measurement data were expressed as mean±standard deviation.The t test was used for comparison between groups.P<0.05 was considered statistically significant.Results In 15 cases of 25 malformed ears undergoing surgery,the auricular cr

关 键 词：招风耳 耳整形 软骨柱法 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]