颅面筋膜多点固定成形矫正杯状耳畸形的临床研究

发布时间：2018-06-27 15:13

本文选题：杯状耳畸形 + 耳廓软骨　；参考：《西南医科大学》2017年硕士论文

【摘要】：目的:研究应用颅面筋膜多点固定成形矫正杯状耳畸形的手术方法及治疗效果。方法:选取2014年1月~2016年3月四川省医学科学院·四川省人民医院整形外科收治的53例Tanzer分型为I、II型的单侧杯状耳畸形患者为研究对象,术前进行患耳耳廓亚单位结构形态的评估及左右两侧耳廓对称度的测量。手术选取耳颅沟切口,暴露、松解耳后肌肉、连接韧带等组织,调节耳廓软骨的位置,重塑缺损或畸形的耳廓亚单位结构。术后3月及术后1年对患者进行随访,评估术后耳廓亚单位结构形态显露情况及耳廓对称度,结果使用SPSS21.0进行统计学分析。结果:本组53例患者手术均顺利完成,其中51例患者在术后未出现相关并发症。2例患者术后出现了血肿,清除血肿后均治愈出院。根据术后3月与术后1年的随访情况对手术效果进行评估,经统计学分析得出:1.耳廓亚单位结构术前与术后评分相比存在差异,且p值0.001,差异具有统计学意义;术后3月与术后1年相比较,p0.05,不具有统计学差异;2.耳廓对称度术前与术后相比存在差异,且p值0.001,差异具有统计学意义,术后3月与术后1年相比较,p0.05,不具有统计学差异。结论:1.颅面筋膜多点固定成形对I、II型杯状耳畸形的治疗有效;2.颅面筋膜多点固定成形治疗I、II型杯状耳畸形术后耳廓形态稳定,患者及家属满意度高;3.颅面筋膜多点固定成形治疗I、II型杯状耳畸形的病例基础是耳廓上半部不存在组织量缺损,畸形的发生与耳廓上半部与耳甲部的异常发育有关;4.对颅面筋膜多点固定成形治疗I、II型杯状耳畸形的远期效果还有待进一步随访研究。
[Abstract]:Objective: to study the surgical treatment of goblet ear malformation with multipoint fixation of craniofacial fascia. Methods: from January 2014 to March 2016, 53 patients with unilateral goblet ear malformation classified by Tanzer as Ig II were selected and treated in the plastic surgery department of Sichuan Provincial people's Hospital of Sichuan Academy of Medical Sciences. The shape of subunit of auricle and the symmetry of left and right auricles were measured before operation. Cranial sulcus incision, exposure, release of posterior ear muscles and ligaments were selected to regulate the position of auricle cartilage and to reconstruct the subunit structure of defect or deformity of auricle. Patients were followed up 3 months after operation and 1 year after operation to evaluate the morphological exposure and symmetry of auricle subunits. Results SPSS 21.0 was used for statistical analysis. Results: all the 53 patients were successfully operated. Among them, 51 cases had no postoperative complications. 2 cases had hematoma after operation, all of them were cured and discharged after removal of hematoma. According to the follow-up of 3 months and 1 year after operation, the effect of the operation was evaluated, and the result of statistical analysis showed that 1: 1. There was significant difference between preoperative and postoperative score of auricular subunit structure (p = 0.001), and there was no significant difference between 3 months after operation and 1 year after operation (P 0.05). There was significant difference in the degree of symmetry of auricle between before and after operation (p value 0.001), but there was no significant difference between 3 months after operation and 1 year after operation (P 0.05). Conclusion 1. Multipoint fixation of craniofacial fascia is effective in the treatment of type II goblet ear deformity. The shape of the auricle was stable and the satisfaction of the patients and their families was high after the operation of cranio-facial fascia multipoint fixation in the treatment of type II goblet ear deformity. The basis of craniofacial fascioplasty in the treatment of type II goblet ear deformity is that there is no tissue defect in the upper half of the auricle, and the occurrence of the deformity is related to the abnormal development of the superior half of the auricle and the teal part of the ear. The long-term effect of multi-point fixation of craniofacial fascia in the treatment of type II goblet ear deformity needs further follow-up study.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R764.9;R622

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