本文選題：杯狀耳畸形 + 耳廓軟骨��； 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究應(yīng)用顱面筋膜多點(diǎn)固定成形矯正杯狀耳畸形的手術(shù)方法及治療效果。方法:選取2014年1月~2016年3月四川省醫(yī)學(xué)科學(xué)院·四川省人民醫(yī)院整形外科收治的53例Tanzer分型為I、II型的單側(cè)杯狀耳畸形患者為研究對象,術(shù)前進(jìn)行患耳耳廓亞單位結(jié)構(gòu)形態(tài)的評估及左右兩側(cè)耳廓對稱度的測量。手術(shù)選取耳顱溝切口,暴露、松解耳后肌肉、連接韌帶等組織,調(diào)節(jié)耳廓軟骨的位置,重塑缺損或畸形的耳廓亞單位結(jié)構(gòu)。術(shù)后3月及術(shù)后1年對患者進(jìn)行隨訪,評估術(shù)后耳廓亞單位結(jié)構(gòu)形態(tài)顯露情況及耳廓對稱度,結(jié)果使用SPSS21.0進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:本組53例患者手術(shù)均順利完成,其中51例患者在術(shù)后未出現(xiàn)相關(guān)并發(fā)癥。2例患者術(shù)后出現(xiàn)了血腫,清除血腫后均治愈出院。根據(jù)術(shù)后3月與術(shù)后1年的隨訪情況對手術(shù)效果進(jìn)行評估,經(jīng)統(tǒng)計學(xué)分析得出:1.耳廓亞單位結(jié)構(gòu)術(shù)前與術(shù)后評分相比存在差異,且p值0.001,差異具有統(tǒng)計學(xué)意義;術(shù)后3月與術(shù)后1年相比較,p0.05,不具有統(tǒng)計學(xué)差異;2.耳廓對稱度術(shù)前與術(shù)后相比存在差異,且p值0.001,差異具有統(tǒng)計學(xué)意義,術(shù)后3月與術(shù)后1年相比較,p0.05,不具有統(tǒng)計學(xué)差異。結(jié)論:1.顱面筋膜多點(diǎn)固定成形對I、II型杯狀耳畸形的治療有效;2.顱面筋膜多點(diǎn)固定成形治療I、II型杯狀耳畸形術(shù)后耳廓形態(tài)穩(wěn)定,患者及家屬滿意度高;3.顱面筋膜多點(diǎn)固定成形治療I、II型杯狀耳畸形的病例基礎(chǔ)是耳廓上半部不存在組織量缺損,畸形的發(fā)生與耳廓上半部與耳甲部的異常發(fā)育有關(guān);4.對顱面筋膜多點(diǎn)固定成形治療I、II型杯狀耳畸形的遠(yuǎn)期效果還有待進(jìn)一步隨訪研究。
[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.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R764.9;R622

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