二期Nagata法耳廓再造与振动声桥同期置入治疗先天性外中耳畸形效果分析  

Analysis of the Effect of Two-stage Nagata Auricle Reconstruction and Simultaneous Placement of Vibration Bridge in the Treatment of Congenital External and Middle Ear Malformations

作　　者：张梦萍 赵斯君[1] 谢丽华[1] ZHANG Mengping;ZHAO Sijun;XIE Lihua(Department of Otolaryngology Head and Neck Surgery,Hunan Children's Hospital,Changsha 410000,Hunan,China)

机构地区：[1]湖南省儿童医院耳鼻咽喉-头颈外科,湖南长沙410000

出　　处：《中国美容医学》2023年第9期65-68,共4页Chinese Journal of Aesthetic Medicine

基　　金：湖南省科技创新计划项目任务书(编号:2017SK50703)。

摘　　要：目的:探究二期Nagata法耳廓再造与振动声桥(Vibrant soundbridge,VSB)同期置入治疗先天性外中耳畸形(Microtia and atresia,MA)的效果。方法:选取2019年1月-2021年9月期间本院收治的55例MA患者。根据治疗方案分为两组,对照组28例,观察组27例。对照组采用三期皮肤软组织扩张术进行耳廓再造,VSB于耳廓再造Ⅲ期同时置入,观察组采用二期Nagata法进行耳廓再造,VSB于Ⅱ期同时置入。术后7 d评估患者耳廓重建效果,听力情况及耳廓外观满意度,同时统计患者术后耳部并发症情况。随访1年后再次评估患者听力情况及耳廓外观满意度。结果:观察组、对照组耳廓再造优良率分别为92.59%(23/27)、89.29%(25/28),两组比较差异无统计学意义(P>0.05);与术前比较,术后7 d及术后1年气导听阈值降低(P<0.05),与术后7 d比较,术后1年气导听阈值降低(P<0.05);观察组MA术后1年气导听阈值低于对照组(P<0.05);观察组术后并发症发生率为7.41%(2/27),低于对照组的28.57%(8/28),P<0.05;观察组、对照组术后7 d耳廓外观满意度分别为88.89%、92.86%,两组比较差异无统计学意义(P>0.05);观察组术后1年耳廓外观满意度分别为88.89%,高于对照组的64.29%(P<0.05)。结论:二期Nagata法耳廓再造与VSB同期置入治疗MA具有良好的耳廓再造效果,能够降低气导听阈值及术后耳部并发症,经长期随访发现该方案仍具有较高的耳廓外观满意度。Objective To explore the efficacy of secondary Nagata auricular reconstruction and concurrent implantation of vibrating soundbridge(VSB)in the treatment of congenital external middle ear malformation(microtia and atresia(MA).Methods Fifty-five patients with MA admitted to our hospital from January 2019 to September 2021 were selected.According to the treatment plan,the patients were divided into two groups:control group(28 cases)and observation group(27 cases).In the control group,three stages of skin and soft tissue dilatation were used for auricle reconstruction,and VSB was inserted simultaneously in the third stage of auricle reconstruction.In the observation group,the second stage Nagata method was used for auricle reconstruction,and VSB was placed in the second stage simultaneously.The effects of auricle reconstruction,hearing status and satisfaction with auricle appearance were evaluated 7 days after surgery,and the postoperative ear complications were counted.After 1 year of follow-up,the patients'hearing and auricle appearance satisfaction were evaluated again.Results The excellent and good rates of auricle reconstruction in observation group and control group were 92.59%(23/27)and 89.29%(25/28),respectively.There was no significant difference between the two groups(P>0.05).Compared with the preoperative,the pure tone hearing threshold was decreased at 7 d and 1 year after surgery(P<0.05),compared with 7 d after surgery,the pure tone hearing threshold was decreased at 1 year after surgery(P<0.05).The pure tone hearing threshold of the observation group was lower than that of the control group 1 year after MA operation(P<0.05).The incidence of postoperative complications in the observation group was 7.41%(2/27),lower than that in the control group(28.57%)(8/28),P<0.05.The satisfaction of auricle appearance in the observation group and the control group was 88.89%and 92.86%,respectively,7 days after surgery,and there was no significant difference between the two groups(P>0.05).The satisfaction of auricle ap

关 键 词：Nagata法 皮肤软组织扩张术 耳廓再造 振动声桥同期置入 先天性外中耳畸形 

分 类 号：R762[医药卫生—耳鼻咽喉科]