Rib Cartilage Assessment Relative to the Healthy Ear in Young Children with Microtia Guiding Operative Timing.
Rib Cartilage Assessment Relative to the Healthy Ear in Young Children with Microtia Guiding Operative Timing.
复制标题
相对于小耳症幼儿健康耳朵的肋骨软骨评估指导手术时机
DOI：
10.4103/0366-6999.162505
复制
发表时间：
2015-08-20
影响因子：
6.1
通讯作者：
Jiang DY
中科院分区：
文献类型：
--
作者：
Kang SS;Guo Y;Zhang DY;Jiang DY
背景：耳廓重建术的最佳年龄是有争议的。肋软骨的生长发育与年龄密切相关，决定着耳廓重建的可行性和效果。我们开发了一种方法来指导年龄从5到10岁的小耳畸形儿童进行耳廓再造的时机。方法：采用低剂量多层螺旋CT对肋骨软骨和健康耳进行评价。测量了健康耳的第8肋软骨和螺旋的长度(从螺旋脚到螺旋和耳垂的连接处)。当两个长度大致相等时进行手术。结果：术前第八肋骨测量值与术中测量值显著相关(P<；0.05)。从5岁到10岁，第八肋骨的生长不是线性的。在121例患者中，76例(62.8%)第八肋骨长度与健耳的螺旋长度大致相等；这些患者获得了满意的结果。18例(14.9%)患者第8根肋骨略短于螺旋，通过调节支架螺旋小腿的长度完成螺旋重建，取得了满意的效果。在17例(14.0%)患者中，通过软骨拼接完成了螺旋结构的制作，获得了可接受的结果。9例(7.4%)肋骨软骨长度不足患者延迟手术。1例(0.8%)肋骨软骨长度不足，没有软骨可供螺旋拼接，结果不满意。结论：第八肋软骨的生长是可变的。相对于健耳的肋骨软骨评估可以指导年轻小耳畸形患者的耳廓重建和个体化治疗。
Background:The optimal age at which to initiate for auricular reconstruction is controversial. Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction. We developed a method to guide the timing of auricular reconstruction in children with microtia ranging in age from 5 to 10 years. Methods:Rib cartilage and the healthy ear were assessed using low-dose multi-slice computed tomography. The lengths of the eighth rib cartilage and the helix of the healthy ear (from the helical crus to the joint of the helix and the earlobe) were measured. Surgery was performed when the two lengths were approximately equal. Results:The preoperative eighth rib measurements significantly correlated with the intraoperative measurements (P < 0.05). From 5 to 10 years of age, eighth rib growth was not linear. In 76 (62.8%) of 121 patients, the eighth rib length was approximately equal to the helix length in the healthy ear; satisfactory outcomes were achieved in these patients. In 18 (14.9%) patients, the eighth rib was slightly shorter than the helix, helix fabrication was accomplished by adjusting the length of the helical crus of stent, and satisfactory outcomes were also achieved. Acceptable outcomes were achieved in 17 (14.0%) patients in whom helix fabrication was accomplished by cartilage splicing. In 9 (7.4%) patients with insufficient rib cartilage length, the operation was delayed. In one (0.8%) patient with insufficient rib cartilage length, which left no cartilage for helix splicing, the result was unsatisfactory. Conclusions:Eighth rib cartilage growth is variable. Rib cartilage assessment relative to the healthy ear can guide auricular reconstruction and personalize treatment in young patients with microtia.