Kuang Yuting,Zhao Sijun,Huang Min,et al.Analysis of psychological status, efficacy, safety and prognostic factors of modified Brent surgery in children with microtia[J].Journal of Clinical Pediatric Surgery,,21():876-880.[doi:10.3760/cma.j.cn101785-202207026-015]
Analysis of psychological status, efficacy, safety and prognostic factors of modified Brent surgery in children with microtia
- Keywords:
- Ear Deformities; Acquired; Root Cause Analysis; Otolaryngology/SU
- Abstract:
- Objective To investigate the efficacy and complications of modified Brent surgery in the treatment of microtia, and to analyze the influencing factors of poor prognosis.Methods A total of 52 children with microtia admitted to Hunan Children’s Hospital from January 2020 to March 2021 were selected as the research objects and divided into Brent surgery group and modified Brent surgery group according to the random number table method, with 26 cases in each group.Brent surgery was performed in the Brent surgery group, The modified Brent surgery group underwent modified Brent surgery, and the modified group was modified by preoperative positioning, cartilage carving and splicing, and adjustment of surgical stages..The complications and microtia score of the two groups were compared, and the influencing factors of poor prognosis of microtia were analyzed by multivariate Logistic regression.Results The small ear condition scores in both groups showed an upward trend, and the scores of T2-T3 in the modified Brent group were higher; the curative effects of the modified Brent surgery group and the Brent surgery group were 92.31% and 69.23%, respectively; the modified Brent surgery group and the Brent group The complication rates were 23.08% and 50.00%, respectively.Risk factors for poor prognosis in children with microtia included younger age, auricle deformity Max Ⅲ and above, external auditory canal atresia grade Ⅲ and above, and the protective factor was modified Brent surgery (P < 0.05).Conclusion Risk factors for poor prognosis include younger age, auricle deformity Max Ⅲ and above, and presence of external auditory canal atresia grade Ⅲ or above. The modified Brent operation can improve the postoperative curative effect of children with microtia, and the risk of postoperative complications is lower, which is worthy of clinical promotion.
References:
[1] 周栩, 刘暾, 王悦, 等.先天性小耳畸形耳廓再造术式的选择与运用[J].中华整形外科杂志, 2017, 33(1):34-39.DOI:10.3760/cma.j.issn.1673-0860.2015.03.004. Zhou X, Liu T, Wang Y, et al.Selections and applications of auricle reconstruction for congenital microtia malformation[J].Chinese Journal of Plastic Surgery, 2017, 33(1):34-39.DOI:10.3760/cma.j.issn.1673-0860.2015.03.004.
[2] 王敏, 赵斯君, 肖志容, 等.先天性小耳畸形的孕期危险因素分析[J].临床小儿外科杂志, 2020, 19(6):534-537, 543.DOI:10.3969/j.issn.1671-6353.2020.06.014. Wang M, Zhao SJ, Xiao ZR, et al.Risk factors of congenital microtia during pregnancy[J].J Clin Ped Sur, 2020, 19(6):534-537, 543.DOI:10.3969/j.issn.1671-6353.2020.06.014.
[3] Alves H, de Rodriguez J, Fernandes T, et al.Prelaminated supraclavicular island flap for total ear reconstruction:a new technique[J].Plast Reconstr Surg Glob Open, 2020, 8(5):e2736.DOI:10.1097/GOX.0000000000002736.
[4] 李辰龙, 谢友舟, 朱雅颖, 等.三期法功能及耳再造技术在先天性小耳畸形伴耳道狭窄患者中的应用[J].中华整形外科杂志, 2018, 34(3):183-187.DOI:10.3760/cma.j.issn.1009-4598.2018.03.005. Li CL, Xie YZ, Zhu YY, et al.Application of three-stage function and ear reconstruction in patients with congenital microtia with ear canal stenosis[J].Chin J Plastic Surgery, 2018, 34(3):183-187.DOI:10.3760/cma.j.issn.1009-4598.2018.03.005.
[5] 江晨艳, 刘政, 康雪然, 等.骨桥在先天性小耳畸形伴外耳道闭锁中的应用[J].中华耳科学杂志, 2019, 17(4):514-518.DOI:10.3969/j.issn.1672-2922.2019.04.013. Jiang CY, Liu Z, Kang XR, et al.Application of bone bridge in congenital microtia with external auditory canal atresia[J].Chin J Otology, 2019, 17(4):514-518.DOI:10.3969/j.issn.1672-2922.2019.04.013.
[6] 王蔚文.临床疾病诊断与疗效判断标准[M].北京:科学技术文献出版社, 2010. Wang WW.Judgment criteria of clinical disease diagnosis and therapeutic efficacy[M].Beijing:Science and Technology Academic Press, 2010.
[7] 匡玉婷, 赵斯君, 黄敏, 等.改良Brent法全耳再造术治疗先天性小耳畸形的临床分析[J].中国耳鼻咽喉颅底外科杂志, 2022, 28(3):26-29.DOI:10.11798/j.issn.1007-1520.202222058. Kuang YT, Zhao SJ, Huang M, et al.Clinical analysis of modified Brent method for total ear reconstruction for congenital microtia[J].Chinese Journal of Otorhinolaryngology and Skull Base Surgery, 2022, 28(3):26-29.DOI:10.11798/j.issn.1007-1520.202222058.
[8] Chen X, Xu Y, Li C, et al.Key genes identified in nonsyndromic microtia by the analysis of transcriptomics and proteomics[J].ACS Omega, 2022, 7(20):16917-16927.DOI:10.1021/acsomega.1c07059.
[9] Lingeshwar D, Appadurai R, Challa P, et al.Auricular retentive prosthetic conformer post Brent’s stage iii surgery in microtia repair:a clinical report[J].J Prosthodont, 2019, 28(2):e817-e821.DOI:10.1111/jopr.12775.
[10] Medved F, Fischb orn T, Rothenberger JM, et al.Reconstruction ofskin and soft tissue defects of the outer ear in patients with severeburn injuries:analysis of three different operative techniques[J].EurJ Plast Surg, 2017, 17(2):517-524.DOI:10.1007/s00238-017-1317-8.
[11] 杨广远, 冷向锋.扩张皮瓣联合自体肋软骨移植法与改良Brent法全耳再造术对矫正先天性小耳畸形效果比较[J].中国耳鼻咽喉头颈外科, 2020, 27(4):229-231.DOI:10.16066/j.1672-7002.2020.04.015. Yang GY, Leng XF.Comparison of efficacies of expanded flap plus autologous costal cartilage transplantation and modified Brent method on reconstructuring congenital microtia[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2020, 27(4):229-231.DOI:10.16066/j.1672-7002.2020.04.015.
[12] 李慧川, 王烨华.基于ADOPT问题解决模式的个体化护理对正颌手术患者心理健康和适应能力的影响[J].中华现代护理杂志, 2020, 26(2):247-251.DOI:10.3760/cma.j.issn.1674-2907.2020.02.022. Li HC, Wang YH.Effect of individualized nursing based on ADOPT on mental health and adaptive ability of orthognathic surgery patients[J].Chin J Modern Nursing, 2020, 26(2):247-251.DOI:10.3760/cma.j.issn.1674-2907.2020.02.022.
[13] 黄进军, 肖乐强, 卢颖洁, 等.改良Nagata法耳再造术治疗先天性小耳畸形[J].南昌大学学报(医学版), 2020, 60(1):57-59.DOI:10.13764/j.cnki.ncdm.2020.01.013. Huang JJ, Xiao LQ, Lu YJ, et al.Improved Nagata reconstruction of congenital microtia ear[J].Journal of Nanchang University (Medical Edition), 2020, 60(1):57-59.DOI:10.13764/j.cnki.ncdm.2020.01.013.
[14] Cao T, Zhang Q.Repair exposure of the postauricular tissue expander using the modified brent method:a 7-year experience[J].Ear Nose Throat J, 2021:1455613211007967.DOI:10.1177/01455613211007967.
Memo
收稿日期:2022-07-15。
基金项目:湖南省出生缺陷协同防治科技重大专项（2019SK1015）； 湖南省科技厅创新引导计划（2017SK50703）
通讯作者:赵斯君,Email:zhsj3991@sohu.com