山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (1): 25-30.doi: 10.6040/j.issn.1673-3770.0.2021.401

• • 上一篇    下一篇

1岁以内婴幼儿耳郭形态畸形矫正效果评价

马孝宝,李越,沈佳丽,孙进,陈向平,杨军,陈建勇   

  1. 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科/上海交通大学医学院耳科学研究所/上海市耳鼻疾病转化医学重点实验室, 上海 200092
  • 出版日期:2022-01-10 发布日期:2022-02-22
  • 通讯作者: 杨军. E-mail:yangjun@xinhuamed.com.cn; 陈建勇. E-mail:chenjianyong@xinhuamed.com.cn
  • 作者简介:马孝宝,李越为共同第一作者
  • 基金资助:
    上海交通大学医工交叉重点项目(ZH2018ZDA11);新华医院院级临床研究培育基金(21XHDB02)

A clinical observation on effect of auricle deformity type and age on outcomes of auricle correction in 1-year-old infants

MA Xiaobao, LI Yue, SHEN Jiali, SUN Jin, CHEN Xiangping, YANG Jun, CHEN Jianyong   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine / Shanghai Jiaotong University School of Medicine Ear Institute /Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
  • Online:2022-01-10 Published:2022-02-22

摘要: 目的 探讨耳郭形态畸形的类型及矫正时的年龄对治疗效果的影响,为临床耳郭形态畸形无创矫正提供参考。 方法 选取2017年9月至2019年9月,以耳鼻咽喉头颈外科门诊确诊为耳郭形态畸形的1岁以内患儿作为研究对象。按开始矫正的年龄分为两组,<42 d为小月龄组,>42 d为大月龄组。同时根据形态畸形的类型分为招风耳组、杯状耳组、垂耳组和隐耳组。采用改良版耳郭形态畸形无创矫正视觉模拟评分法(MVAS-NAC)对小月龄组和大月龄组患儿的矫形效果进行对比分析。 结果 小月龄组平均提升效果优于大月龄组(P<0.05),患儿矫正年龄与矫正效果呈负相关,小月龄组和大月龄组矫正时长差异无统计学意义(P>0.05),不同耳郭形态畸形组之间平均提升效果差异无统计学意义(P>0.05)。家长评分与医生评分差异无统计学意义(P>0.05),家长和医生评分斯皮尔曼等级相关系数r=0.810小月龄组皮肤并发症发生率低于大月龄组(P<0.05)。 结论 年龄是影响矫正效果的主要因素,超过6个月的患儿,不再推荐进行矫正治疗,隐耳可适当放宽矫正年龄。临床可采用MVAS-NAC进行矫正效果的评估。

关键词: 耳郭, 形态畸形, 无创矫正, 年龄

Abstract: Objective To explore the influence of auricle deformity type and age at the time of correction on the outcomes in order to provide references for clinical non-surgical correction of the auricle. Methods Infants with auricle deformity diagnosed in the ENT department between September 2017 and September 2019 were selected as the subjects. They were divided into two groups based on the age within 1 year. Infants less than 42 days were in the younger group, and infants more than 42 days were in the older group. The type of auricle deformity was divided into prominent ears, cup ears, lop ears, and cryptotia. The modified visual analogue scale in non-surgical auricle correction(MVAS-NAC)was used to evaluate the outcomes. Results The outcomes of the younger group were better than those of the older group(P<0.05). The relationship between the age at correction and the outcome was generally negative(P<0.05). The difference in the duration of treatment between the younger group and the older group was not statistically significant(P>0.05). No significant difference was found in the outcome among the different type of deformity groups (P>0.05). No statistical difference was seen between parents' score and doctor's score(P>0.05). The Spearman rank correlation coefficient between the parents and the doctor was 0.810. The incidence of skin complications in the younger group was lower than that in the older group(P<0.05). Conclusion The age of correction is the main factor affecting the effect of correction. Infants with age above 6 months must not be recommended for auricle correction; for infants with cryptotia, the age limitation can be relaxed. MVAS-NAC can initially be used to evaluate the effect of non-invasive correction of auricle deformities in infants.

Key words: Auricle, Auricle deformity, Non-surgical auricle correction, Age

中图分类号: 

  • R764
[1] Zhao H, Ma LM, Qi XD, et al. A morphometric study of the newborn ear and an analysis of factors related to congenital auricular deformities[J]. Plast Reconstr Surg, 2017, 140(1): 147-155. doi:10.1097/PRS.0000000000003443.
[2] Byrd HS, Langevin CJ, Ghidoni LA. Ear molding in newborn infants with auricular deformities[J]. Plast Reconstr Surg, 2010, 126(4): 1191-1200. doi:10.1097/PRS.0b013e3181e617bb.
[3] 王登元, 陈智斌, 陈若希,等. 印迹法耳后皮瓣制备及修复耳郭前部皮肤缺损的临床效果[J]. 山东大学耳鼻喉眼学报, 2017, 31(3):68-70. doi:10.6040/j.isn.1673-3770.0.2016.536. WANG Dengyuan,CHEN Zhibin,CHEN Ruoxi, et al. Clinical efficacy of repairing auricular skin defects with posterior auricular flaps and their preparation with Gauzebloting[J]. JOTOLARYNGOL OPHTHALSHANDONG UNIV, 2017, 31(3):68-70. doi:10.6040/j.isn.1673-3770.0.2016.536.
[4] Mutaf M, Temel M. A new cartilage-sparing procedure for correction of the prominent ear deformity: dermal anchor technique[J]. Ann Plast Surg, 2020, 85(3): 221-228. doi:10.1097/SAP.0000000000002257.
[5] Chang CS, Bartlett SP. Deformations of the ear and their nonsurgical correction[J]. Clin Pediatr(Phila), 2019, 58(7): 798-805. doi:10.1177/0009922819844296.
[6] Chan SLS, Lim GJS, Por YC, et al. Efficacy of ear molding in infants using the EarWell infant correction system and factors affecting outcome[J]. Plast Reconstr Surg, 2019, 144(4): 648e-658e. doi:10.1097/PRS.0000000000006057.
[7] 王艳杰, 程冯丽, 赵长青. 3D打印技术应用于耳鼻咽喉科临床前瞻创新[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 114-118. doi:10.6040/j.issn.1673-3770.0.2019.538. WANG Yanjie, CHENG Fengli, ZHAO Changqing. Latest research progress of 3D printing technology and clinical applications in otorhinolaryngology[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 114-118.doi:10.6040/j.issn.1673-3770.0.2019.538.
[8] 中华医学会耳鼻咽喉头颈外科学分会小儿学组. 先天性耳郭畸形耳模矫正技术专家共识[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(5): 330-333. doi:10.3760/cma.j.issn.1673-0860.2019.05.003. Subspecialty Group of Pediatrics,Society of Otorhinolaryngology Head and Neck Surgery,Chinese Medical Association.Expertconsensus on ear molding for congenital auricular deformation[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2019, 54(5): 330-333. doi:10.3760/cma.j.issn.1673-0860.2019.05.003.
[9] Schonauer F, la Rusca I, Molea G. Non-surgical correction of deformational auricular anomalies[J]. J Plast Reconstr Aesthet Surg, 2009, 62(7): 876-883. doi:10.1016/j.bjps.2007.11.072.
[10] 钟贞, 刘玉和, 张俊波, 等. 100天内大龄儿先天性耳郭畸形无创矫正长期疗效观察[J]. 中华耳科学杂志, 2020, 18(3): 469-474. doi:10.3969/j.issn.1672-2922.2020.03.009. ZHONG Zhen, LIU Yuhe, ZHANG Junbo,et al. Long-term observation of ear molding in older infants within 100 days with congenital auricular deformities[J]. Chinese Journal of Otology, 2020, 18(3): 469-474. doi:10.3969/j.issn.1672-2922.2020.03.009.
[11] Hunter AGW, Yotsuyanagi T. The external ear: more attention to detail may aid syndrome diagnosis and contribute answers to embryological questions[J]. Am J Med Genet A, 2005, 135(3): 237-250.doi:10.1002/ajmg.a.30723.
[12] 忻蓉, 蒋黎艳, 方艳璋, 等. 新生儿耳郭形态畸形临床研究[J]. 中国耳鼻咽喉头颈外科, 2018, 25(10): 541-543. doi:10.16066/j.1672-7002.2018.10.007. XIN Rong, JIANG Liyan, FANG Yanzhang, et al. Clinical study on neonatal auricle deformity[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2018, 25(10): 541-543. doi:10.16066/j.1672-7002.2018.10.007.
[13] Chang CS, Bartlett SP. A simplified nonsurgical method for the correction of neonatal deformational auricular anomalies[J]. Clin Pediatr(Phila), 2017, 56(2): 132-139. doi:10.1177/0009922816641368.
[14] Matsuo K, Hayashi R, Kiyono M, et al. Nonsurgical correction of congenital auricular deformities[J]. Clin Plast Surg, 1990, 17(2): 383-395.
[15] 王小亚, 黄靖茹, 魏玮, 等. 275例新生儿耳郭形态的随访研究[J]. 中华耳科学杂志, 2021, 19(4): 603-607. doi:10.3969/j.issn.1672-2922.2021.04.012. WANG Xiaoya, HUANG Jingru, WEI Wei, et al. A follow-upsurvey of auricle morphology in 275 neonates[J]. Chinese Journal of Otology, 2021, 19(4): 603-607. doi:10.3969/j.issn.1672-2922.2021.04.012.
[16] Lennon C, Chinnadurai S. Nonsurgical management of congenital auricular anomalies[J]. Facial Plast Surg Clin North Am, 2018, 26(1): 1-8. doi:10.1016/j.fsc.2017.09.001.
[17] Doft MA, Goodkind AB, Diamond S, et al. The newborn butterfly project: a shortened treatment protocol for ear molding[J]. Plast Reconstr Surg, 2015, 135(3): 577e-583e. doi:10.1097/PRS.0000000000000999.
[18] Feijen MMW, van Cruchten C, Payne PE, et al. Non-surgical correction of congenital ear anomalies: a review of the literature[J]. Plast Reconstr Surg Glob Open, 2020, 8(11): e3250. doi:10.1097/GOX.0000000000003250.
[19] Gulati RD, Faraci N, Butts SC. Neonatal ear molding[J]. Laryngoscope, 2021, 131(2): E423-E427. doi:10.1002/lary.28842.
[20] Woo T, Kim YS, Roh TS, et al. Correction of congenital auricular deformities using the ear-molding technique[J]. Arch Plast Surg, 2016, 43(6): 512-517. doi:10.5999/aps.2016.43.6.512.
[21] 刘清明, 田野, 於娟娟, 等. 新生儿耳郭筛查图库管理和随访系统的研发和临床应用[J]. 中华耳科学杂志, 2021, 19(6): 1008-1012. doi:10.3969/j.issn.1672-2922.2021.06.025. LIU Qingming, TIAN Ye, YU Juanjuan, et al. Development and clinical application of A neonatal auricle screening library management and follow-up system[J]. Chinese Journal of Otology, 2021, 19(6): 1008-1012. doi:10.3969/j.issn.1672-2922.2021.06.025.
[22] Daniali LN, Rezzadeh K, Shell C, et al. Classification of newborn ear malformations and their treatment with the EarWell infant ear correction system[J]. Plast Reconstr Surg, 2017, 139(3): 681-691. doi:10.1097/PRS.0000000000003150.
[23] Wang D, Jiang HY, Yang QH, et al. Non-surgical correction of cryptotia and the analysis of treatment time and other influence factors[J]. Int J Pediatr Otorhinolaryngol, 2020, 129: 109771. doi:10.1016/j.ijporl.2019.109771.
[24] 苏钰, 丁志伟, 马坚凌. 新生儿耳郭畸形的早期认识和无创矫治[J]. 中华耳科学杂志, 2018, 16(1): 38-41. doi:10.3969/j.issn.1672-2922.2018.01.012. SU Yu, DING Zhiwei, MA Jianling. Deformational auricularanomalies in newborn infants: early recognition and non-surgical correction[J]. Chinese Journal of Otology, 2018, 16(1): 38-41. doi:10.3969/j.issn.1672-2922.2018.01.012.
[25] Woo JE, Park YH, Park EJ, et al. Effectiveness of ear splint therapy for ear deformities[J]. Ann Rehabil Med, 2017, 41(1): 138-147. doi:10.5535/arm.2017.41.1.138.
[1] 张青, 陈耔辰, 赵欢娣, 魏馨雨, 张玉忠, 胡娟, 李岑菲, 刘英, 许信达, 杨军. 年龄因素对直流电刺激诱发的前庭诱发肌源性电位的影响[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 7-13.
[2] 沈佳丽, 孙夏雨, 陈向平, 杨军, 陈建勇, 汪玮, 张勤, 王璐, 马孝宝, 贺宽, 沈敏. 听力正常儿童骨导前庭诱发肌源性电位正常值的建立[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 72-77.
[3] 伊海金,杨仕明. 重视耳部外伤诊疗工作[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 1-3.
[4] 张生军,尹承江,宋丽,王仁彩,王启荣. 改良前囊壁切除联合对穿缝合法治疗耳郭假性囊肿32例[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 42-45.
[5] 薄琳,刘新刚,刘玉红,苏法仁. 扩张皮瓣加筋膜瓣“两瓣法”在小耳畸形患者耳郭再造中的应用[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 49-51.
[6] 张贵阳,黄河,冼志,张汉文,谢桂彩. 粉尘螨滴剂舌下含服免疫治疗对不同年龄段变应性鼻炎患者的临床效果评估[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 60-65.
[7] 郝创利,顾文婧. 认识不同年龄儿童慢性咳嗽的病因[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 20-24.
[8] 冀帅飞,张婕,严宏. 年龄相关性黄斑变性患者人工晶状体的选择[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 36-39.
[9] 王翠,颜昕,赵博军. IVR联合PDT治疗湿性年龄相关性黄斑变性的临床观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 94-97.
[10] 刘露,梁皓. 中老年白内障人群角膜散光的分布规律[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 75-77.
[11] 赵露,谢国丽,王艳玲. 玻璃体腔注射雷珠单抗对湿性年龄相关性黄斑变性患者眼血流动力学的影响[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 101-104.
[12] 陈春丽, 宋宗明, 贾新国, 周仲楼, 汪朝阳. 促红细胞生成素抑制氧化损伤诱导的人眼Müller细胞凋亡[J]. 山东大学耳鼻喉眼学报, 2015, 29(3): 65-71.
[13] 宋盛华, 赵伟, 蒋金琴, 赵梦莹. 不同方法治疗耳郭瘢痕疙瘩35例[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 19-23.
[14] 薄琳, 苏法仁, 刘新刚, 丁静华. 手术治疗耳郭假性囊肿45例[J]. 山东大学耳鼻喉眼学报, 2014, 28(6): 16-17.
[15] 朱亚骄, 薛飞, 王秋萍. 90例耳鸣患者心理声学特征研究[J]. 山东大学耳鼻喉眼学报, 2014, 28(5): 14-17.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 周斌,李滨 . 鼻内窥镜下鼻窦鼻息肉手术75例疗效观察[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 24 -26 .
[2] 张玉光,韩旭光,张华,王旭,徐湘辉 . 改良穿透性角膜移植术治疗真菌性角膜炎[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 94 -95 .
[3] 隆梅辉,何明强,牟艳云,田利健 . 上颌窦炎性肌纤维母细胞瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2008, 22(4): 329 -330 .
[4] 邹 俊,卢 奕,褚仁远 . 体外培养人胚晶状体上皮细胞生长特性的研究[J]. 山东大学耳鼻喉眼学报, 2008, 22(5): 453 -456 .
[5] 夏文清,郑 敏,满晓飞,李建平 . 手法劈核治疗老年性白内障[J]. 山东大学耳鼻喉眼学报, 2008, 22(5): 467 -469 .
[6] 李学昌,王金磊,张玉莉,董文汇,韩在文 . 中药冲洗对鼻黏膜纤毛超微结构的影响[J]. 山东大学耳鼻喉眼学报, 2006, 20(6): 522 -524 .
[7] 康宏建,李晓红,王保安,周 涛 . 重型颅脑损伤患者行气管切开术的意义[J]. 山东大学耳鼻喉眼学报, 2007, 21(3): 234 -236 .
[8] 闫 蕊,朱淋洁 . 翼状胬肉显微手术切除后角膜干细胞移植[J]. 山东大学耳鼻喉眼学报, 2007, 21(3): 243 -244 .
[9] 黄 方,朱从月 . p21、p73及PTEN在头颈部多原发癌中的表达及意义[J]. 山东大学耳鼻喉眼学报, 2007, 21(5): 388 -392 .
[10] 徐豪杰,李学忠,陈成芳,王学海 . 鼻内镜下鼻腔泪囊吻合术17例[J]. 山东大学耳鼻喉眼学报, 2008, 22(2): 132 -134 .