Reconstruction of Congenital Microtia-Atresia Outcomes With the Medpor/Bone-Anchored Hearing Aid Approach
Reconstruction of Congenital Microtia-Atresia Outcomes With the Medpor/Bone-Anchored Hearing Aid Approach
复制标题
DOI：
10.1097/sap.0b013e31819fae51
复制
发表时间：
2009-04-01
影响因子：
1.5
通讯作者：
Kohan, Darius
中科院分区：
文献类型：
--
作者：
Romo, Thomas, III;Morris, Luc G. T.;Kohan, Darius
理想的先天性小闭锁手术将提供良好的美容和听力康复，与最低的发病率。经典的方法需要多个程序，包括肋骨软骨切除和耳闭锁修复。我们的面部整形和耳科团队采用高密度多孔聚乙烯（Medpor, Porex Surgical, Newnan， GA）耳廓框架，随后进行单级骨锚定助听器（BAHA）植入。我们评估了这种两阶段双系统方法的有效性、安全性和发病率。在2003年至2006年期间，我们使用了一个小耳畸形患者的前瞻性数据库来识别接受Medpor/BAHA联合耳廓重建和听力康复的患者。第一阶段包括在颞顶筋膜瓣下放置Medpor框架，随后是第二阶段的小叶移位和BAHA植入。对25例患者（28耳）进行评估。植入物的美学质量非常好，可见高度的框架细节，所有患者均出现耳后折痕。所有患者对美容效果都很满意。没有主要的Medpor并发症，如感染、挤压、种植体丢失或皮瓣坏死，10.7%的轻微并发症发生率需要手术翻修。BAHA显著改善了所有患者的听力，并发症发生率为31.8%，主要是皮肤过度生长和蜂窝织炎。与传统的微创闭锁修复相比，Medpor/BAHA双整形-耳科方法治疗微创闭锁产生了良好的美容效果和听力效果。这是一个两阶段的美学和功能方案，具有可接受的低并发症率，安全有效地实现了美学和功能目标。
Ideal surgery for congenital microtia-atresia would offer excellent cosmetic and hearing rehabilitation, with minimal morbidity. Classic approaches require multiple procedures, including rib cartilage harvest and aural atresia repair. Our facial plastic and otologic team approach incorporates a high-density porous polyethylene (Medpor, Porex Surgical, Newnan, GA) auricular framework, followed by single-stage bone-anchored hearing aid (BAHA) implantation. We evaluated the efficacy, safety, and morbidity of this 2-stage dual system approach.A prospective database of microtia patients was used to identify patients undergoing combined Medpor/BAHA auricular reconstruction and hearing rehabilitation between 2003 and 2006.The first stage involves placement of a Medpor framework beneath a temporoparietal fascia flap, followed by a second-stage procedure for lobule transposition and BAHA implantation.Twenty-five patients (28 ears) were evaluated. Aesthetic quality of the implants was excellent, with a high degree of framework detail visible, and a postauricular crease created in all patients. All patients were satisfied with the cosmetic result. There were no major Medpor complications such as infection, extrusion, loss of implant, or flap necrosis, and a 10.7% incidence of minor complications requiring operative revision. BAHA significantly improved hearing in all patients, with a complication rate of 31.8%, mainly skin overgrowth and cellulitis.The Medpor/BAHA dual plastic-otologic approach to microtia-atresia has produced excellent cosmetic results and hearing outcomes, which compare favorably to traditional microtia-atresia repair. This is a 2-stage aesthetic and functional protocol with an acceptably low rate of complications, which safely and efficiently achieves both aesthetic and functional goals.