Biomechanical Evaluation of Surgical Correction of Prominent Ear
Biomechanical Evaluation of Surgical Correction of Prominent Ear
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DOI：
10.1097/prs.0b013e318199f098
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发表时间：
2009-03-01
影响因子：
3.6
通讯作者：
Nakajima, Tatsuo
中科院分区：
文献类型：
--
作者：
Miyamoto, Junpei;Nagasao, Tomohisa;Nakajima, Tatsuo
背景资料：Mustarde缝合和耳甲内收术被广泛用于手术矫正突出的耳朵，并且伴随这两种方法的许多软骨操作技术也是可用的。然而，目前尚不清楚每种技术如何在生物力学上起作用。方法：采用非接触式三维数字化仪获取8只前凸耳的数据，制作耳廓软骨三维模型。这些模型被修改为软骨操作模型：舟骨切口，磨损，外耳切口，和外耳切除模型。然后将对应于Mustarde缝线的载荷施加到无操作、舟骨切口和磨损模型。将对应于耳甲后退的载荷施加到无操作、耳甲切口和耳甲切除模型。应力和变形的形状进行了评估，使用有限元方法。结果：当Mustarde缝线和外耳缩进比较，在无操作模型，最大应力发生在Mustarde缝线的负载和在外耳缩进的螺旋的根部。整个耳朵奠定了在外耳挫折，而在Mustarde缝，强烈的弯曲发生在上三分之一。在Mustarde缝线中，最大应力降低到82%（肩胛骨切口）和95%（磨损）。然而，在这两个模型中，挫折效应也有所减少。在耳甲后退中，耳甲切开或切除可显着降低高应力。结论：对于成功的耳成形术，准确的了解生物力学反应是必不可少的。这项研究为许多外科医生提供了对耳成形术的更深入的了解。（Plast。重建123：889，2009）。
Background: Mustarde sutures and conchal setback are widely used for surgical correction of prominent ear, and numerous cartilage-manipulation techniques accompanying these two methods are also available. However, it is unknown how each technique works biomechanically. The effects of otoplasty were evaluated by finite element analysis.Methods: Data of eight prominent ears were obtained with a noncontact three-dimensional digitizer, and three-dimensional auricular cartilage models were produced. These models were modified to cartilage-manipulation models: scaphal-incision, abrasion, conchal-incision, and conchal-excision models. The loads corresponding to Mustarde sutures were then applied to the no-manipulation, scaphal-incision, and abrasion models. Loads corresponding to conchal setback were applied to the no-manipulation, conchal-incision, and conchal-excision models. Stresses and deformed shapes were evaluated using finite element method.Results: When Mustarde sutures and conchal setback were compared in the no-manipulation models, maximal stresses occurred around loads in Mustarde sutures and at the root of the helix in conchal setback. The entire ear laid down in conchal setback, whereas in Mustarde sutures, strong bending occurred at the upper third. In Mustarde sutures, maximal stresses decreased to 82 percent with scaphal incision and 95 percent with abrasion. However, the setback effect was also reduced in these two models. In conchal setback, high stresses were markedly decreased with conchal incision or excision. There was no significant difference between incision and excision.Conclusions: For successful otoplasty, precise understanding of biomechanical reactions is essential. This study provides improved insight into otoplasty for many surgeons. (Plast. Reconstr. Surg. 123: 889, 2009.)