耳廓矫形器适应证拓展研究  

A Study on Expanded Indications for Auricle Orthosis

作　　者：段晓晗 张铭 林佳华 邹艺辉[1,2] DUAN Xiaohan;ZHANG Ming;LIN Jiahua;ZOU Yihui(College of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Beijing,China;National Clinical Research Center for Otolaryngologic Diseases,Beijing,China)

机构地区：[1]中国人民解放军总医院耳鼻咽喉头颈外科医学部,北京100853 [2]国家耳鼻咽喉疾病临床医学研究中心,北京100853

出　　处：《中华耳科学杂志》2023年第3期350-355,共6页Chinese Journal of Otology

基　　金：军委后保计生专项课题(编号22JSZ14);国家临床医学中心专项课题(编号202100003);专利转化专项基金(编号42411D19)。

摘　　要：目的 探索超指南适应证(3月龄内、耳廓形态畸形)的先天性耳廓畸形患者矫形器矫治的效果,尝试拓展耳廓矫形器适应证。方法 先天性耳廓畸形26例(35耳),年龄3月~8岁,男12例(18耳),女14例(17耳),形态畸形24例(33耳),结构畸形2例(2耳)。其中包括术后2例(3耳):形态畸形(招风耳)1例(2耳),结构畸形(小耳畸形)1例(1耳)。均采用EarWell耳廓矫正器治疗,效果与家属满意度采用先天性耳廓畸形耳模矫正指南标准,效果分显效或治愈、有效、无效3个等级,家属满意度分很满意、满意、一般、不满意、很不满意5个等级。结果 3月~8岁的26例(35耳)总有效率77.1%(27/35),显效或治愈率为31.4%(11/35)。其中≥1岁患者矫治总有效率61.5%(8/13),结构畸形2例均有效;术后矫治2例,年龄≥6岁,均有效。家属满意与很满意共68.6%(24/35)。结论 耳廓矫形器矫治对先天性耳廓畸形超指南适应证仍有效,包括时间窗3月~8岁(尤其≥1岁者)、结构畸形(小耳畸形)及≥6岁术后辅助塑形都有效。因此,在临床对超指南的此类患者条件允许时可以考虑尝试,拓展了耳廓矫形器的适应证。Objective To report effectiveness of orthotic treatment for congenital auricular malformations in children aging beyond the guidelines(within 3 months of age)for the possibility to expand indications for auricular orthotics.Method Children aged from 3 months to 8 years(n=26,35 ears)with congenital auricular malformations were treated with the EarWell Ear Correction Kit.Of these children,12 were male(18 ears)and 14 were female(17 ears).Deformity was morphological in 24 cases(33 ears)and structural in 2 cases(2 ears).Two patients(3 ears)had previous surgeries for morphological deformity(Cryptotia,2 ears)or structural deformity(Microtitia,1 ear).Treatment effectiveness and family satisfaction were evaluated in accordance to the guidelines for correction of congenital auricle deformities.Correction outcomes were rated as effective,partially effective and ineffective,and the family satisfaction as very satisfied,satisfied,neutral,dissatisfied and very dissatisfied.Results Correction was rated as effective or partially effective in 27 cases,(77.1%),including effective in 11 cases(31.4%).In the 13 children≥1 year old,correction was rated as effective or partially effective in 8 cases(61.5%).Correction was rated as effective in the 2 patients with structural deformity and in the 2 patients with history of previous surgeries(both aged≥6 years).Families of 24 patients(68.6%)were satisfied or very satisfied with treatment outcomes.Conclusion Auricle orthosis remains an effective treatment for congenital auricular malformations at ages beyond those defined in the guidelines,especially for those≥1 year old and those with structural malformations(e.g.microtia)and those in whom previous surgery has failed(even≥6 years of age in this study).Treatment trials can be considered for select patients despite an age exceeding those in guidelines,thus expanding the indications of auricular orthotics.

关 键 词：先天性耳廓畸形 耳廓矫形器 矫治效果 适应症拓展 

分 类 号：R764[医药卫生—耳鼻咽喉科]