Journal of Plastic Reconstructive and Aesthetic Surgery最新文献_第8页

Understanding the heterogenicity of unicoronal synostosis – A morphometric analysis of cases compared to controls 了解单冠突触症的异质性--病例与对照组的形态计量分析

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-18 DOI: 10.1016/j.bjps.2024.09.044

H. Lif , J. Nysjö , M. Geoffroy , G. Paternoster , M. Taverne , R. Khonsari , D. Nowinski

Background

Preoperative severity of unicoronal synostosis varies greatly and involves the frontal bone, skull base and orbits. Degree of deformity affects long-term morphological and functional outcomes after surgery. The aim of this study was to describe the morphological heterogenicity and investigate its relation to patient-specific factors.

Materials and methods

In this retrospective cohort study, non-syndromic unicoronal synostosis patients treated between 2006 and 2022 at Necker Hospital, France or Uppsala University Hospital, Sweden, were included and matched to controls. Severity of skull base, orbital and posterior skull asymmetry, degree of anterior plagiocephaly and Harlequin deformity, lateralisation, head circumference, age, timing of metopic fusion and fusion of peri-pterionic sutures were investigated.

Results

Ninety-five patients and ninety-three controls were included. Skull base asymmetry was linearly related to orbital asymmetry (p < 0.001), correlated with earlier CT scans (p = 0.004) and anterior (p < 0.001) and posterior (p = 0.03) plagiocephaly. Posterior plagiocephaly was more common in patients (31%) compared with controls (5%) (p < 0.001). A patent metopic suture above nine months of age was associated with severe Harlequin deformity (p = 0.04) and a lower head circumference when fused (p = 0.03). Fronto-sphenoidal suture fusion was associated with later CT scans (p < 0.001) and less skull base asymmetry (p = 0.002). Spheno-parietal fusion was correlated with decreased skull base asymmetry (p = 0.03). Right lateralisation was more common in females.

Conclusions

Heterogenicity of unicoronal synostosis seems to be predominantly explained by variability in skull base morphology. Peri-pterionic fusions might limit deformity.

背景单冠状突触症的术前严重程度差异很大，涉及额骨、颅底和眼眶。畸形程度会影响术后的长期形态和功能预后。本研究旨在描述形态异质性，并探讨其与患者特异性因素的关系。材料与方法在这项回顾性队列研究中，纳入了2006年至2022年间在法国内克尔医院或瑞典乌普萨拉大学医院接受治疗的非综合征单侧突眼患者，并与对照组进行了配对。研究对象包括颅底、眼眶和后颅骨不对称的严重程度、前颅畸形和哈勒金畸形的程度、侧位、头围、年龄、元骨融合的时间以及颅骨周围缝合的融合情况。颅底不对称与眼眶不对称呈线性关系（p < 0.001），与较早的 CT 扫描（p = 0.004）、前方（p < 0.001）和后方（p = 0.03）颅外畸形相关。与对照组（5%）相比，患者（31%）的后颅畸形更为常见（p < 0.001）。九个月以上的蝶骨缝通畅与严重的哈勒金畸形（p = 0.04）和融合后头围较低有关（p = 0.03）。前额蝶骨缝融合与较晚的 CT 扫描（p < 0.001）和较少的颅底不对称（p = 0.002）有关。椎旁融合与颅底不对称程度降低有关（p = 0.03）。结论单侧突眼的异质性似乎主要是由颅底形态的变异造成的。蝶骨周围融合可能会限制畸形。

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引用次数: 0

Indications and outcomes for locoregional perforator propeller flaps in head and neck reconstruction: Topographical approach in 83 patients 头颈部重建中局部穿孔器螺旋桨皮瓣的适应症和疗效：83例患者的地形方法

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-18 DOI: 10.1016/j.bjps.2024.09.056

Semih Baghaki , Seha Yanki Sezgin , Nuri Efe Aydin , Ali Coskunturk , Can Ege Yalcin , Servet Yekta Aydın , Cemal Burak Sirkeci

Background

Local perforator flaps have been used in head and neck for coverage of relatively small defects. In this study, we aimed to present our results using a wide spectrum of locoregional flaps in perforator propeller fashion in reconstruction of moderate-to-large sized soft tissue defects of the head and neck.

Patients and methods

From August 2012 to June 2023, a total of 83 patients with moderate to large-sized soft tissue defects of the head and neck underwent reconstruction using locoregional perforator propeller flaps. Data on the etiology and location of the defect, the flap of choice and the postoperative course were gathered from patients’ charts retrospectively. Clinical outcome was evaluated based on parameters such as flap survival, color match, duration of hospitalization, and subjective satisfaction of the patient.

Results

A total of 92 locoregional perforator propeller flaps were used in 83 patients with skin and soft tissue defects of the head and neck. The follow-up period ranged from 3 and 36 months, with an average follow-up duration of 12 months. The duration of hospitalization varied between 1 and 6 days, averaging 3 days. Distal partial flap loss occurred in 3 patients, while no postoperative infection, hematomas or seromas were observed.

Conclusion

Locoregional perforator propeller flaps provide reproducible, functional and aesthetic results in reconstruction of moderate-to-large sized soft tissue defects of the head and neck.

背景局部穿孔器皮瓣一直用于头颈部相对较小的缺损。在这项研究中，我们旨在展示我们在重建头颈部中到大型软组织缺损时使用各种穿孔器螺旋桨式局部皮瓣的结果。患者和方法从 2012 年 8 月到 2023 年 6 月，共有 83 例头颈部中到大型软组织缺损患者接受了局部穿孔器螺旋桨皮瓣重建术。我们从患者的病历中回顾性地收集了有关缺损的病因和位置、皮瓣选择和术后过程的数据。结果 83例头颈部皮肤和软组织缺损患者共使用了92个局部穿孔螺旋桨皮瓣。随访时间从 3 个月到 36 个月不等，平均随访时间为 12 个月。住院时间从1天到6天不等，平均为3天。结论定位区域穿孔器螺旋桨皮瓣在重建头颈部中大型软组织缺损方面具有可重复性、功能性和美观性。

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引用次数: 0

Comments on “A single-center retrospective comparison of muscle versus cutaneous free flaps for posterior elbow defect reconstruction” 关于 "单中心回顾性比较肘关节后部缺损重建中肌肉瓣与皮下游离瓣 "的评论

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-18 DOI: 10.1016/j.bjps.2024.09.051

José Antonio Arellano, Mario Alessandri-Bonetti, Hilary Y. Liu, Francesco M. Egro

引用次数: 0

Breaking down the concrete wall: Encouraging trickle-down allyship in plastic and reconstructive surgery training 打破水泥墙：在整形外科培训中鼓励涓滴同盟关系

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-18 DOI: 10.1016/j.bjps.2024.09.057

Isra Abdulwadood, Sonal Kumar, Shelley S. Noland

引用次数: 0

Integrating SMAS plication and deep plane techniques in facial rejuvenation: A novel approach 在面部年轻化中整合 SMAS plication 和深平面技术：一种新方法

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-17 DOI: 10.1016/j.bjps.2024.09.033

Fatih Cinar , Ugur Celik

Introduction

In facial rejuvenation surgeries, deep plane facelift and superficial musculoaponeurotic system (SMAS) plication techniques have been applied with notable efficacy over an extended period, yielding aesthetically pleasing outcomes. Both methods have their own advantages and disadvantages depending on the individual circumstances. We endeavored to formulate an effective facelift method by integrating these approaches, aiming to harness the advantageous aspects of each method while addressing their respective drawbacks in a comprehensive manner.

Methods

Following the preparation of the subcutaneous plane overlying the fixed SMAS, the mobile SMAS was elevated from the deep plane, and a SMAS flap was fashioned. The SMAS flap in the prezygomatic and premasseteric areas was inwardly folded, and a plication procedure was applied using loop sutures from its most medial to lateral aspects. Subsequently, it was secured to the preauricular area with U stitches. The results were statistically evaluated preoperatively and postoperatively using the wrinkle severity rating scale (WSRS) scores.

Results

A total of 40 patients underwent the operative procedures effectively performed by the senior author (F.C.). Preoperative WSRS scores were 4.2 ± 0.52. Postoperative WSRS scores at 3 months were significantly lower at 1.25 ± 0.44 (p < 0.05). The facelift procedure was effectively applied in all patients without the development of major complications.

Conclusions

This method combines deep plane facelift and surgical SMAS plication, using the advantages of both techniques to directly address the nasolabial folds and achieve gratifying outcomes in facial and neck rejuvenation.

导言：在面部年轻化手术中，深平面拉皮和浅层肌肉神经系统（SMAS）植入技术已被长期应用，并取得了显著的疗效，产生了美观的效果。这两种方法各有利弊，视个人情况而定。我们努力将这两种方法结合起来，制定出一种有效的拉皮方法，旨在利用每种方法的优点，同时全面解决它们各自的缺点。方法在准备好固定 SMAS 上的皮下平面后，将移动 SMAS 从深面抬起，并制作 SMAS 皮瓣。将颧骨前和颌前区域的 SMAS 皮瓣向内折叠，并使用环形缝线从最内侧到外侧进行缝合。随后，用 U 形针将其固定在耳前区域。结果共有 40 名患者接受了由资深作者（F.C.）有效实施的手术。术前 WSRS 评分为 4.2 ± 0.52。术后 3 个月的 WSRS 评分明显降低，为 1.25 ± 0.44（p < 0.05）。结论这种方法结合了深层平面拉皮和手术 SMAS plication，利用两种技术的优势直接解决鼻唇沟问题，在面部和颈部年轻化方面取得了令人满意的效果。

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引用次数: 0

Comment on “Donor-site safety in microvascular lymph node transfer for breast cancer–related lymphedema using reverse lymphatic mapping – A prospective study” 关于 "利用反向淋巴管图谱进行微血管淋巴结转移治疗乳腺癌相关淋巴水肿的供体部位安全性--一项前瞻性研究 "的评论

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-17 DOI: 10.1016/j.bjps.2024.09.032

Luigi Losco

引用次数: 0

Dissociated urethral plate Onlay and standard Onlay urethroplasty for mid-distal hypospadias: A comparative study 分离式尿道板嵌顿尿道成形术和标准嵌顿尿道成形术治疗中段尿道下裂：比较研究

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-17 DOI: 10.1016/j.bjps.2024.09.046

Xiao-Yu Li , Li-Xia Wang , Jia-Xuan Wang, Sai-Sai Liu, Xiao-Jiang Zhu, Yi-Min Yuan, Yun-Fei Guo, Zheng Ge , Li-Qu Huang

Background

Urethral plate (UP) reserved Onlay urethroplasty is currently used widely in mid-distal hypospadias. However, for children with 15–30° residual curvature after degloving, only dorsal tunica albuginea plication is performed to correct penile ventral curvature (VC), and long-term follow-up showed a high recurrence rate of penile curvature. We developed a modified Onlay urethroplasty, which dissociates the UP and completely removes the tissue beneath the UP to fully correct penile curvature. Furthermore, we compared it with the standard Onlay urethroplasty to explore its rationality and feasibility.

Methods

We prospectively collected clinical data from 68 children with hypospadias who underwent standard or modified Onlay urethroplasty between September 2019 and June 2021, and evaluated the interim outcomes to identify the complications between the two groups. Additionally, we conducted histological examination of the tissue beneath the UP.

Results

A total of 32 patients underwent modified Onlay urethroplasty. Intraoperative curvature measurements showed that 37.5% (12/32) of the patients had completely straightened their penis after UP dissection and removal of the fibrous tissue beneath it. A total of 36 patients underwent standard Onlay urethroplasty. Totally, five fistulas each were reported in the first and second groups, and the complication rates were 15.6% and 13.9%, respectively (P > 0.05). The histological results showed that the tissue below the UP contains a large amount of collagen, mainly type I collagen.

Conclusion

The dissociated UP Onlay urethroplasty can maximally remove factors limiting penis growth and completely correct penile curvature, without increasing the incidence of postoperative complications. Therefore, we recommend the application of the improved Onlay urethroplasty in children with mid-distal hypospadias.

背景尿道板（UP）保留 Onlay 尿道成形术目前广泛用于中段尿道下裂。然而，对于脱帽术后有15-30°残余弯曲的患儿，仅采用背侧白膜成形术来矫正阴茎腹侧弯曲（VC），而长期随访显示阴茎弯曲的复发率很高。我们开发了一种改良的Onlay尿道成形术，它能分离UP并完全切除UP下方的组织，从而完全矫正阴茎弯曲。方法我们前瞻性地收集了2019年9月至2021年6月期间接受标准或改良Onlay尿道成形术的68名尿道下裂患儿的临床数据，并对中期结果进行了评估，以确定两组患儿的并发症情况。此外，我们还对UP下方的组织进行了组织学检查。结果共有32名患者接受了改良Onlay尿道成形术。术中弧度测量结果显示，37.5%（12/32）的患者在UP剥离并切除其下方的纤维组织后，阴茎完全变直。共有 36 名患者接受了标准的 Onlay 尿道成形术。第一组和第二组各报告了 5 例瘘管，并发症发生率分别为 15.6% 和 13.9% （P> 0.05）。组织学结果显示，UP下方的组织中含有大量胶原蛋白，主要是I型胶原蛋白。因此，我们推荐在中段尿道下裂患儿中应用改良的Onlay尿道成形术。

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引用次数: 0

Establishing an equipoise: Does the use of acellular dermal matrices in pre-pectoral implant-based breast reconstruction improve outcomes? 建立平衡：在胸大肌前植入假体的乳房重建中使用非细胞真皮基质是否能改善效果？

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-17 DOI: 10.1016/j.bjps.2024.09.041

Hannah Cook , David Zargaran , Sevasti Panagiota Glynou , Alexander Zargaran , Mo Akhavani , Norman Williams , Stephen Hamilton , Afshin Mosahebi

Introduction

Breast cancer is the most common malignancy among women in the United Kingdom. Surgical management commonly comprises mastectomy and reconstruction, of which implant-based breast reconstruction (IBBR) is the most prevalent. Acellular dermal matrices (ADM) are widely used in pre-pectoral IBBR; however, there is limited high-quality evidence supporting their efficacy. This study aimed to establish an equipoise via an expert consensus survey.

Methods

An online survey was designed with a steering group of experts. Questions covered participant information, opinions regarding surgical outcomes with ADM use in pre-pectoral IBBR and opinions regarding the available scientific evidence on the topic. The survey was advertised via national and international professional organisations. Quantitative and qualitative analyses were performed.

Results

Thirty-two participants from the UK, Italy and Australia completed the survey. Key findings of this study included disagreement among participants regarding the surgical outcomes associated with ADM use. Participants who believed that ADM reduced the risk of short-term complications and implant failure/explantation comprised a minority (21.9%). Participants who felt that ADM use improved cosmetic outcomes and reduced long-term complications were a relative majority at 43.8% and 40.6%, respectively. Furthermore, 56.3% of the participants felt that there was scarce scientific evidence on the topic.

Conclusions

This study provides insights from international surgeons, establishing a lack of consensus on surgical outcomes, efficacy and evidence-base supporting the use of ADMs in pre-pectoral IBBR. Given this clinical equipoise, alongside the growing burden of breast cancer associated morbidity and need for reconstruction, the implications of this study are that large-scale, prospective, randomised-controlled data are needed to establish whether ADM use in pre-pectoral breast reconstruction improves the outcomes.

导言乳腺癌是英国妇女最常见的恶性肿瘤。手术治疗通常包括乳房切除和重建，其中植入物乳房重建（IBBR）最为普遍。细胞真皮基质（ADM）被广泛应用于胸大肌前乳房重建，但支持其疗效的高质量证据却很有限。本研究旨在通过专家共识调查建立一种平衡。问题包括参与者信息、对口腔前 IBBR 使用 ADM 的手术效果的看法以及对该主题现有科学证据的看法。调查通过国内和国际专业组织进行宣传。来自英国、意大利和澳大利亚的 32 名参与者完成了调查。本研究的主要发现包括：参与者对使用 ADM 所带来的手术效果存在分歧。认为 ADM 可降低短期并发症和种植失败/移植风险的参与者占少数（21.9%）。认为使用 ADM 可改善外观效果和减少长期并发症的参与者相对占多数，分别为 43.8% 和 40.6%。此外，56.3% 的参与者认为有关该主题的科学证据很少。结论这项研究提供了来自国际外科医生的见解，确定了在手术结果、疗效和证据基础方面缺乏支持在胸前 IBBR 中使用 ADM 的共识。鉴于这种临床上的不一致，以及乳腺癌相关发病率和重建需求的不断增长，本研究的意义在于需要大规模、前瞻性、随机对照数据来确定在胸大肌前乳房重建中使用 ADM 是否能改善手术效果。

{"title":"Establishing an equipoise: Does the use of acellular dermal matrices in pre-pectoral implant-based breast reconstruction improve outcomes?","authors":"Hannah Cook , David Zargaran , Sevasti Panagiota Glynou , Alexander Zargaran , Mo Akhavani , Norman Williams , Stephen Hamilton , Afshin Mosahebi","doi":"10.1016/j.bjps.2024.09.041","DOIUrl":"10.1016/j.bjps.2024.09.041","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer is the most common malignancy among women in the United Kingdom. Surgical management commonly comprises mastectomy and reconstruction, of which implant-based breast reconstruction (IBBR) is the most prevalent. Acellular dermal matrices (ADM) are widely used in pre-pectoral IBBR; however, there is limited high-quality evidence supporting their efficacy. This study aimed to establish an equipoise via an expert consensus survey.</div></div><div><h3>Methods</h3><div>An online survey was designed with a steering group of experts. Questions covered participant information, opinions regarding surgical outcomes with ADM use in pre-pectoral IBBR and opinions regarding the available scientific evidence on the topic. The survey was advertised via national and international professional organisations. Quantitative and qualitative analyses were performed.</div></div><div><h3>Results</h3><div>Thirty-two participants from the UK, Italy and Australia completed the survey. Key findings of this study included disagreement among participants regarding the surgical outcomes associated with ADM use. Participants who believed that ADM reduced the risk of short-term complications and implant failure/explantation comprised a minority (21.9%). Participants who felt that ADM use improved cosmetic outcomes and reduced long-term complications were a relative majority at 43.8% and 40.6%, respectively. Furthermore, 56.3% of the participants felt that there was scarce scientific evidence on the topic.</div></div><div><h3>Conclusions</h3><div>This study provides insights from international surgeons, establishing a lack of consensus on surgical outcomes, efficacy and evidence-base supporting the use of ADMs in pre-pectoral IBBR. Given this clinical equipoise, alongside the growing burden of breast cancer associated morbidity and need for reconstruction, the implications of this study are that large-scale, prospective, randomised-controlled data are needed to establish whether ADM use in pre-pectoral breast reconstruction improves the outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"99 ","pages":"Pages 23-29"},"PeriodicalIF":2.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Five-item modified frailty index does not outperform diabetes and hypertension alone in prediction of complications after breast reconstruction 在预测乳房再造术后并发症方面，五项改良虚弱指数并不优于单纯的糖尿病和高血压指数

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-17 DOI: 10.1016/j.bjps.2024.09.055

Dylan K. Kim, Christine H. Rohde

Purpose

Existing literature has emphasized the utility of the five-item modified frailty index (mFI-5) in predicting postoperative outcomes after surgical procedures. However, in breast reconstruction, a primarily elective post-oncologic procedure for otherwise relatively healthy patients, several components of the index may be sparse and not strongly contribute to predictive value.

Methods

Breast reconstruction cases were identified in the 2012–2022 National Surgical Quality Improvement Program. Three metrics were compared in this cohort: 1) the mFI-5, 2) a simplified two-item index comprising diabetes and/or hypertension, and 3) American Society of Anesthesiologists (ASA) class. Each metric was incorporated into three multivariate logistic regression models for occurrence of at least one postoperative complication. Predictive performance among metrics was compared over fifty iterations (p < 0.05). Performance was compared between autologous and implant-based modalities in a supplementary analysis.

Results

134,983 breast reconstruction cases were identified in the final cohort. In multivariate regression, both MFI and the two-item index of diabetes and hypertension were significant predictors of postoperative complications (p < 0.001). The mFI-5 (average AUC: 0.6106) and two-item index (average AUC: 0.6105) performed without significant difference (p = 0.93). Discriminatory performance of ASA class (average AUC: 0.6115), was not significantly different from the other metrics (p > 0.05).

Conclusions

In the context of a population of mainly elective breast reconstruction procedures, the five-item modified frailty index does not outperform an index of diabetes and hypertension alone. Such findings may motivate the selection of other variables that may be more useful for prediction of postoperative outcomes.

目的现有文献强调了五项改良虚弱指数（mFI-5）在预测外科手术术后结果方面的实用性。然而，对于乳房再造这种主要针对相对健康患者的选择性肿瘤术后手术，该指数的几个组成部分可能比较稀疏，对预测价值的贡献不大。在该队列中比较了三个指标：1）mFI-5；2）包含糖尿病和/或高血压的简化双项指标；3）美国麻醉医师协会（ASA）等级。每个指标都被纳入三个多变量逻辑回归模型，以预测至少一种术后并发症的发生。在 50 次迭代中比较了各指标的预测性能（p < 0.05）。在一项补充分析中，对自体和植入方式的预测效果进行了比较。在多变量回归中，MFI 和糖尿病与高血压双项指数都是术后并发症的重要预测因素（p < 0.001）。mFI-5（平均AUC：0.6106）和双项目指数（平均AUC：0.6105）的表现无明显差异（p = 0.93）。结论在以选择性乳房再造手术为主的人群中，五项改良虚弱指数并不优于单纯的糖尿病和高血压指数。这些发现可能促使人们选择其他变量来预测术后结果。

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引用次数: 0

Cartilage-sparing otoplasty – 288 ears in 3 years 软骨保留耳廓成形术 - 3 年内完成 288 只耳朵。

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-09-17 DOI: 10.1016/j.bjps.2024.09.031

Shani Gilron , Nathaniel Weiss , Elizaveta Kouniavski , Dana Egozi , Luda Dolgunin , Michal Benkler

Background

Standard methods of otoplasty may risk anatomical distortion. Previous work showcased a novel, cartilage-sparing technique. This study aimed to confirm the safety and effectiveness of the method in a larger cohort.

Methods

This retrospective study included patients undergoing otoplasty by a single surgeon using a single technique between January 2021 and December 2023. Eligible patients were aged >5 years and had prominent or constricted or cup ears, forming a 2 cm distance from the mastoid. Surgical techniques included novel key-point sutures. Minimum follow-up was 6 months. Data on demographics, risk factors, perioperative management, and complications were collected from patient records.

Results

A total of 288 operated ears (147 patients) were included. The mean age was 17 years, and 91 (61.9%) were female. The mean duration of follow-up was 24.3 months. Postoperative complications were generally minor and included Polydioxanone (PDS) suture exposure (n = 16, 5.5%), manageable postoperative pain (n = 8, 2.7%), self-resolving swelling (n = 8, 2.7%), minor bleeding (n = 7, 2.4%), and superficial skin complications (n = 4, 1.3%). Infections occurred in 4 ears (1.3%) and were treated effectively with topical/oral antibiotics. Cases of partial release of the ear resolved without intervention (n = 4, 1.3%). Only 4 (1.3%) ears experienced loss of correction, with options for reoperation available as needed. Analysis showed no significant age differences in postoperative complications and a nonsignificant trend towards higher postoperative swelling in males than in females (10.7% vs 2.2%; P = 0.054).

Conclusions

The data confirms that this technique offers safe and rapid cartilage-sparing otoplasty with minimal complications and low recurrence rates. It ensures long-lasting and aesthetically pleasing results for prominent ear deformities.

Level of evidence

Level III

背景：耳廓成形术的标准方法可能存在解剖变形的风险。之前的研究展示了一种新颖的软骨保留技术。本研究的目的是在更大的群体中证实该方法的安全性和有效性：这项回顾性研究纳入了2021年1月至2023年12月期间由一名外科医生采用单一技术进行耳廓成形术的患者。符合条件的患者年龄大于 5 岁，耳朵突出或收缩或杯状，与乳突形成 2 厘米的距离。手术技术包括新型关键点缝合。最少随访 6 个月。从患者病历中收集了有关人口统计学、风险因素、围手术期管理和并发症的数据：结果：共纳入了 288 例手术耳（147 例患者）。平均年龄为 17 岁，其中 91 人（61.9%）为女性。平均随访时间为 24.3 个月。术后并发症一般较轻，包括聚二氧酮（PDS）缝线外露（16 例，占 5.5%）、可控制的术后疼痛（8 例，占 2.7%）、肿胀自行消退（8 例，占 2.7%）、轻微出血（7 例，占 2.4%）和表皮并发症（4 例，占 1.3%）。有 4 只耳朵（1.3%）发生感染，并通过局部/口服抗生素得到了有效治疗。耳朵部分松动的病例无需干预即可治愈（4 例，1.3%）。只有 4 只耳朵（1.3%）出现了矫正功能丧失的情况，可根据需要选择重新手术。分析表明，术后并发症的年龄差异不明显，男性术后肿胀率高于女性的趋势不明显（10.7% vs 2.2%; P = 0.054）：数据证实，该技术可提供安全、快速、并发症少、复发率低的软骨保留耳廓整形术。结论：数据证实，该技术可提供安全、快速的软骨切除耳廓整形术，并发症少，复发率低，可确保突出耳廓畸形患者获得持久、美观的效果：证据等级：三级。

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引用次数: 0