超时间窗轻度隐耳畸形无创矫正的疗效分析  

Outcomes of Noninvasive Correction of Mild Cryptotia Deformity beyond Optimal Time Window

作　　者：许慧娟 杨海涛 丁韶洸 谢存存 贾晓东 王广科 刘宏建 XU Huijuan;YANG Haitao;DING Shaoguang;XIE Cuncun;JIA Xiaodong;WANG Guangke;LIU Hongjian(Department of Otolaryngology Head and Neck Surgery,People’s Hospital of Henan University,Henan Provincial People’s Hospital,Zhengzhou 450003;Zheng Dong Mi Huan Clinic,Zhengzhou 450003;Department of Otolaryngology Head and Neck Surgery,Henan Provincial People’s Hospital,People’s Hospital of Zhengzhou University,People’s Hospital of Henan University Zhengzhou 450003)

机构地区：[1]河南大学人民医院、河南省人民医院耳鼻咽喉头颈外科,郑州450003 [2]郑东蜜獾诊所,郑州450003 [3]河南省人民医院、郑州大学人民医院、河南大学人民医院耳鼻咽喉头颈外科,郑州450003

出　　处：《中华耳科学杂志》2022年第4期581-588,共8页Chinese Journal of Otology

摘　　要：目的 探讨超时间窗轻度隐耳畸形无创矫正的疗效及合适的时间窗口。方法 收集2016年到2021年无创耳廓矫正器治疗轻度隐耳病例72例,按照患儿治疗时的年龄分为两组,试验组的年龄分布为6个月-14岁(≥6个月即超时间窗),共36例;对照组的年龄分布为6个月以内,共36例,结束后至少随访3个月,比较两组之间无创耳廓矫正的有效率、复发率和治疗时长。试验组根据年龄再分为4个亚组(6月-1岁组、1-3岁组、3-6岁组及≥6岁组),比较其无创矫正的治疗时长。结果 试验组的有效率为94.4%,对照组的有效率为100%,两组之间的有效率无统计学差异(P=0.473)。试验组的复发率为5.6%,对照组的复发率为0,两组之间的复发率无统计学差异(P=0.473)。试验组的治疗时长为(77±52.1)d,对照组的治疗时长为(30±11.8)d,两组之间的治疗时长有统计学差异(P=0)。72例患儿治疗时长与治疗时年龄之间的关联性有统计学差异(P=0,R=0.718)。试验组4个亚组无创矫正的治疗时长有统计学差异(P=0.002),具体为6月-1岁组与3-6岁组有统计学差异(P=0),6月-1岁组与≥6岁组有统计学差异(P=0.002),1-3岁组、3-6岁组和≥6岁组之间无统计学差异。结论 超时间窗轻度隐耳畸形无创矫正的成功率高,可以积极治疗;72例患儿治疗时长与治疗时年龄之间存在正相关关系,即随着年龄的增长,治疗时长也在增长。建议把时间窗口最大放宽到6岁,但需要特别注意在矫正前需要详细告知患儿家属开始矫正时的年龄越大其所需要的矫正时间越长,根据隐耳局部的皮肤张力和粘连情况及软骨硬度来把控矫正时的年龄。Objective To report outcomes and appropriate time window for noninvasive correction of mild cryptotia deformity.Methods A total of 72 cases of mild cryptotia treated by noninvasive auricle orthodontics from 2016 to2021 were collected and divided into two groups based on age at the time of treatment.Children older than 6 months(n=36) were designated as the study group(namely beyond the optimal time window) while those younger than 6 months(n=36) served as the control.The children were followed up for at least 3 months after treatment.The rate of improvement and recurrence as well as treatment duration were compared between the two groups.The study group was further divided into 4 age subgroups(6 months-1 year,1-3 years,3-6 years and ≥6 years) to compare treatment duration required.Results The rate of improvement in the study group was 94.4%,compared to 100% in the control group(P=0.473),and the rate of recurrence in the study group was 5.6%,compared to 0 in the control group(P=0.473).Average treatment duration was 77±52.1 das for the study group and 30±11.8 days for the control group,respectively(P=0).Age at treatment was significantly correlated to treatment duration(P=0,R=0.718).Treatment durations were different for the 4 subgroups of the study group(P=0.002),specifically between the 6 months-1 years and 3-6 years subgroups(P=0) and between the 6 months-1 years and ≥6 years subgroups(P=0.002),but not among the 1-3 years,3-6 years and ≥6 years subgroups.Conclusion Noninvasive correction of mild cryptotia beyond the optimal time window can be highly successful and should be actively considered.Treatment duration increased with age at treatment.Our findings suggest that the time window for noninvasive correction of mild cryptotia should be extended to 6 years,although attention is needed to inform the family before correction in older children that longer treatment time is needed.Age should be considered together with skin tension,adhesion near cryptotia and cartilage rigidity.

关 键 词：隐耳 耳廓形态畸形 无创矫正 

分 类 号：R764[医药卫生—耳鼻咽喉科]