Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery · 2015
[Three-stage surgery of combining auricle reconstruction, meatoplasty and tympanoplasty for patients with congenital microtia-atresia].
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Lichun Zhang, Ying Chen, Tianyu Zhang
Аннотация
OBJECTIVE: To investigate the validity and feasibility of consecutive three-stage surgical technique of combining auricle reconstruction with external auditory canal atresia reconstruction in patients with congenital microtia-atresia, and to assess the post-surgery results by cosmetic and hearing aspects.
METHODS: From Sep. 2007 to Jun. 2011, all 74 patients (79 ears) with congenital microtia-atresia treated in our department were enrolled in this study. They consecutively accepted the following three-stage surgical technique: The first stage was Brent' s technique as follows, rib cartilage graft harvest, framework fabrication, and implantation. The second stage combined transfer of the lobule with meatoplasty and tympanoplasty. The third stage was the elevation of the reconstructed auricle. Both the cosmetic and functional hearing results were recorded at follow-ups.
RESULTS: Among these patients, 60 patients (78.5%), 62 ears, acquired extremely satisfactory cosmetic results; 10 patients (16.5%), 13 ears, acquired acceptable cosmetic results; while the remaining 4 patients (5.1%) acquired unsatisfactory cosmetic results. However, the height of elevation of the newly performed auricle framework was not enough due to the existence of newly formed external ear canal. Regarding the hearing results, there were 69 ears with followup audiograms. An air-bone gap (ABG) improvement of 12.5 dB was achieved. The air-conduction hearing threshold improved (10.9 ± 8.2) dBHL, 37 ears (53.6%) achieved serviceable hearing after surgery, with ABG less than 30 dB. There were multiple complications occurred after surgery with the incidence of 49.4% (39/79).
CONCLUSIONS: The combined three-stage surgical microtia and canal atresia reconstruction technique is a viable choice for some suitable patients with microtia-atresia. However, the incidence of complication after meatoplasty is very high and the hearing restoration is not good enough, which need further investigation for the better results.
METHODS: From Sep. 2007 to Jun. 2011, all 74 patients (79 ears) with congenital microtia-atresia treated in our department were enrolled in this study. They consecutively accepted the following three-stage surgical technique: The first stage was Brent' s technique as follows, rib cartilage graft harvest, framework fabrication, and implantation. The second stage combined transfer of the lobule with meatoplasty and tympanoplasty. The third stage was the elevation of the reconstructed auricle. Both the cosmetic and functional hearing results were recorded at follow-ups.
RESULTS: Among these patients, 60 patients (78.5%), 62 ears, acquired extremely satisfactory cosmetic results; 10 patients (16.5%), 13 ears, acquired acceptable cosmetic results; while the remaining 4 patients (5.1%) acquired unsatisfactory cosmetic results. However, the height of elevation of the newly performed auricle framework was not enough due to the existence of newly formed external ear canal. Regarding the hearing results, there were 69 ears with followup audiograms. An air-bone gap (ABG) improvement of 12.5 dB was achieved. The air-conduction hearing threshold improved (10.9 ± 8.2) dBHL, 37 ears (53.6%) achieved serviceable hearing after surgery, with ABG less than 30 dB. There were multiple complications occurred after surgery with the incidence of 49.4% (39/79).
CONCLUSIONS: The combined three-stage surgical microtia and canal atresia reconstruction technique is a viable choice for some suitable patients with microtia-atresia. However, the incidence of complication after meatoplasty is very high and the hearing restoration is not good enough, which need further investigation for the better results.