Two-stage auriclular reconstruction combined with Bonebridge implantation in patients with congenital microtia
10.3760/cma.j.cn114453-20200213-00042
- VernacularTitle:二期法耳廓再造同期置入骨桥在先天性小耳畸形中的应用
- Author:
Yue WANG
1
;
Shouqin ZHAO
;
Bingqing WANG
;
Qingguo ZHANG
Author Information
1. 中国医学科学院北京协和医学院整形外科医院外耳再造中心 100144
- Keywords:
Congenital microtia;
Ear auricle;
Hearing;
Bonebridge implantation
- From:
Chinese Journal of Plastic Surgery
2021;37(3):309-314
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of two-stage auricular reconstruction combined with Bonebridge implantation in the treatment of congenital microtia.Methods:The clinical data of 52 patients with congenital microtia and hearing impairment were retrospectively analyzed. The patients were admitted to the Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Beijing Tongren Hospital Affiliated to Capital Medical University from June 2017 to August 2019. There were 35 males and 17 females, aged 6-12 years. All patients received the two-stage surgery. The first stage surgery was Nagata’s technique described as follows: rib cartilage harvest and framework implantation. The second stage surgery combined auricle elevation with Bonebridge implantation. Postoperative follow-up was conducted to evaluate the effect of the operation through auricular morphology and auditory evaluation. The auricular morphology was subjectively evaluated by the patient and the patient’s family members. The audiometric evaluation mainly included the comparisons of the pure tone audiometry results and speech recognition rate of the patients before and after the operation. SPSS 19.0 software was used for data analysis. The measurement data were showed as Mean±SD, and the comparison results were analyzed by paired t test. P<0.05 was considered statistically significant. Results:After follow-ups of 3-10 months, with an average of 6 months, the spatial three-dimensional structure and local subunit morphology of the reconstructed ears were satisfactory in 47 patients (90.4%). Four patients had obvious scarring or keloid in retroauricular region, which affected the aesthetic outcome. The results of pure tone audiometry at 3 weeks after surgery showed that the postoperative air conduction threshold was (38.8±7.2) dB HL, which decreased by (33.6±6.2) dB HL compared to that before surgery (72.4±9.0) dB HL, and the difference was statistically significant ( t=38.13, P<0.001). The speech recognition rate was increased by 24%-67%, which was improved from 31.9% before surgery to 85.0% after surgery. The difference was statistically significant ( t=-40.15, P<0.001). Conclusions:Auricular reconstruction and Bonebridge implantation were carried out in one stage of surgery, so that the patients with congenital microtia could obtain good auricular morphology and improve their hearing significantly.
