多孔聚乙烯支架在耳再造中的临床应用
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摘要
耳再造的方法包括自体软骨移植、异体软骨移植和假体植入。自体肋软骨支架的优点是无排异反应,但其获取有限、对胸壁损伤大、雕刻也存在难度。异体软骨支架的缺点是易吸收、变形。目前,研究表明相比自体肋软骨支架,多孔聚乙烯支架(Medpor)具有更好的美学效果、可更早实施手术治疗、更短的手术时间、更少的手术步骤、更简单的术后恢复等优点。本文旨在讨论应用多孔聚乙烯支架的耳再造术的优势和手术方法的最近进展。
Techniques of auricular reconstruction involve autologous graft, allotransplant and prosthetic implant. Autologous grafts cause no rejection but donor-site morbidity and pain. Allotransplants can be absorbed and deformed. Recent studies have shown that the superiorities of porous polyethylene implant(Medpor frameworks) compared to autologous graft are better aesthetic results, earlier age of surgery, shorter operating time, fewer operating procedures, faster postoperative recovery. This article is to discuss the advantages of application of Medpor(porous polyethylene) framework used for auricular reconstruction and the process of surgical procedures.
Techniques of auricular reconstruction involve autologous graft, allotransplant and prosthetic implant. Autologous grafts cause no rejection but donor-site morbidity and pain. Allotransplants can be absorbed and deformed. Recent studies have shown that the superiorities of porous polyethylene implant(Medpor frameworks) compared to autologous graft are better aesthetic results, earlier age of surgery, shorter operating time, fewer operating procedures, faster postoperative recovery. This article is to discuss the advantages of application of Medpor(porous polyethylene) framework used for auricular reconstruction and the process of surgical procedures.
引文
[1]Olshinka A,Louis M,Truong T A.Autologous Ear Reconstruction[J].Seminars in Plastic Surgery,2017,31(03):146-151.DOI:10.1055/s-0037-1603959
[2]Storck K,Staudenmaier R,Buchberger M,et al.Total Reconstruction of the Auricle:Our Experiences on Indications and Recent Techniques[J].Biomed Research International,2014,2014(3):373286.DOI:10.1155/2014/373286
[3]Rueckert F,Brown F E,Tanzer R C.Overview of experience of Tanzer's group with microtia.[J].Clinics in Plastic Surgery,1990,17(2):223.
[4]Brent B.Microtia repair with rib cartilage grafts:a review of personal experience with 1000 cases.[J].Clinics in Plastic Surgery,2002,29(2):257-271.DOI:10.1016/S0094-1298(01)00013-X
[5]Baluch N,Nagata S,Park C,et al.Auricular reconstruction for microtia:A review of available methods.[J].Plastic Surgery,2014,22(1):39.
[6]M.Anghinoni,C.Bailleul,A.S.Magri.Auricular reconstruction of congenital microtia:personal experience in 225 cases[J].Acta otorhinolaryngologica Italica:organo ufficiale della Societàitaliana di otorinolaringologia e chirurgia cervico-facciale,2015,35(3):191-197.
[7]Cabin J A,Bassiri-Tehrani M,Sclafani A P,et al.Microtia Reconstruction:Autologous Rib and Alloplast Techniques[J].Facial Plastic Surgery Clinics of North America,2014,22(4):623-638.DOI:10.1016/j.fsc.2014.07.004
[8]Cronin,Thomas D.Use of a Silastic Frame for Total and Subtotal Reconstruction of the External Ear[J].Plastic and Reconstructive Surgery,1966,37(5):399-405.DOI:10.1097/00006534-196605000-00003
[9]Thorne C H,Brecht L E,Bradley J P,et al.Auricular reconstruction:indications for autogenous and prosthetic techniques.[J].Plastic&Reconstructive Surgery,2001,107(5):1241-1252.DOI:10.1097/00006534-200104150-00024
[10]Hamzavi,Sasan.Porous Polyethylene Implant and Rib Cartilage in Ear Reconstruction:A Comparison[J].Facial Plastic Surgery,2015,31(06):611-616.DOI:10.1055/s-0035-1569061
[11]Fuchs J C,Tucker A S.Development and Integration of the Ear[J].Current Topics in Developmental Biology,2015,115(s 1-2):213.DOI:10.1016/bs.ctdb.2015.07.007
[12]Reinisch J.Ear Reconstruction in Young Children[J].Facial Plastic Surgery,2015,31(06):600-603.DOI:10.1055/s-0035-1568138
[13]Berghaus A,Stelter K,Naumann A,et al.Ear Reconstruction with Porous Polyethylene Implants[J].Adv Otorhinolaryngol,2010,68:53-64.DOI:10.1007/s00106-010-2226-3
[14]Braun T,Gratza S,Becker S,et al.Auricular Reconstruction with Porous Polyethylene Frameworks:Outcome and Patient Benefit in 65 Children and Adults[J].Plastic and Reconstructive Surgery,2010,126(4):1201-1212.DOI:10.1097/prs.0b013e3181ebe391
[15]Romo T III,Reitzen SD.Aesthetic microtia reconstruction with Medpor.Facial Plast Surg2008;24(01):120-128.DOI:10.1055/s-2008-1037453
[16]Romo T III,Morris LG,Reitzen SD,Ghossaini SN,Wazen JJ,Kohan D.Reconstruction of congenital microtia-atresia:outcomes with the Medpor/bone-anchored hearing aid-approach.Ann Plast Surg 2009;62(04):384-389.DOI:10.1097/SAP.0b013e31819fae51
[17]Bosilj D,Arko D,B Gori?ek,et al.Ear Reconstruction Using a Porous Polyethylene Framework and Temporoparietal Fascia Flap[J].Facial Plastic Surgery,2009,25(03):181-189.DOI:10.1055/s-0029-1239448
[18]Helling E R,Okoro S,Kim G,et al.EndoscopeAssisted Temporoparietal Fascia Harvest for Auricular Reconstruction[J].Plastic and Reconstructive Surgery,2008,121(5):1598-1605.DOI:10.1097/prs.0b013e31816a9fb9
[19]Fernandes J R,Driscoll D N.Burn Ear Reconstruction Using Porous Polyethylene Implants and Tissue Expansion[J].Journal of Burn Care&Research,2016,37(4):e348-e352.DOI:10.1097/bcr.0000000000000294
[20]Kim Y S,Yun I S,Chung S.Salvage of Ear Framework Exposure in Total Auricular Reconstruction[J].Annals of Plastic Surgery,2016:1.DOI:10.1097/sap.0000000000000839
[21]Cenzi R,Farina A,Zuccarino L,et al.Clinical Outcome of 285 Medpor Grafts used for Craniofacial Reconstruction[J].Journal of Craniofacial Surgery,2005,16(4):526-530.DOI:10.1097/01.scs.0000168761.46700.dc
[22]Hempel J M,Kn?bl D,Berghaus A,et al.Prospective assessment of quality of life after auricular reconstruction with porous polyethylene.[J].Hno,2014,62(8):564-569.DOI:10.1007/s00106-014-2833-5
[2]Storck K,Staudenmaier R,Buchberger M,et al.Total Reconstruction of the Auricle:Our Experiences on Indications and Recent Techniques[J].Biomed Research International,2014,2014(3):373286.DOI:10.1155/2014/373286
[3]Rueckert F,Brown F E,Tanzer R C.Overview of experience of Tanzer's group with microtia.[J].Clinics in Plastic Surgery,1990,17(2):223.
[4]Brent B.Microtia repair with rib cartilage grafts:a review of personal experience with 1000 cases.[J].Clinics in Plastic Surgery,2002,29(2):257-271.DOI:10.1016/S0094-1298(01)00013-X
[5]Baluch N,Nagata S,Park C,et al.Auricular reconstruction for microtia:A review of available methods.[J].Plastic Surgery,2014,22(1):39.
[6]M.Anghinoni,C.Bailleul,A.S.Magri.Auricular reconstruction of congenital microtia:personal experience in 225 cases[J].Acta otorhinolaryngologica Italica:organo ufficiale della Societàitaliana di otorinolaringologia e chirurgia cervico-facciale,2015,35(3):191-197.
[7]Cabin J A,Bassiri-Tehrani M,Sclafani A P,et al.Microtia Reconstruction:Autologous Rib and Alloplast Techniques[J].Facial Plastic Surgery Clinics of North America,2014,22(4):623-638.DOI:10.1016/j.fsc.2014.07.004
[8]Cronin,Thomas D.Use of a Silastic Frame for Total and Subtotal Reconstruction of the External Ear[J].Plastic and Reconstructive Surgery,1966,37(5):399-405.DOI:10.1097/00006534-196605000-00003
[9]Thorne C H,Brecht L E,Bradley J P,et al.Auricular reconstruction:indications for autogenous and prosthetic techniques.[J].Plastic&Reconstructive Surgery,2001,107(5):1241-1252.DOI:10.1097/00006534-200104150-00024
[10]Hamzavi,Sasan.Porous Polyethylene Implant and Rib Cartilage in Ear Reconstruction:A Comparison[J].Facial Plastic Surgery,2015,31(06):611-616.DOI:10.1055/s-0035-1569061
[11]Fuchs J C,Tucker A S.Development and Integration of the Ear[J].Current Topics in Developmental Biology,2015,115(s 1-2):213.DOI:10.1016/bs.ctdb.2015.07.007
[12]Reinisch J.Ear Reconstruction in Young Children[J].Facial Plastic Surgery,2015,31(06):600-603.DOI:10.1055/s-0035-1568138
[13]Berghaus A,Stelter K,Naumann A,et al.Ear Reconstruction with Porous Polyethylene Implants[J].Adv Otorhinolaryngol,2010,68:53-64.DOI:10.1007/s00106-010-2226-3
[14]Braun T,Gratza S,Becker S,et al.Auricular Reconstruction with Porous Polyethylene Frameworks:Outcome and Patient Benefit in 65 Children and Adults[J].Plastic and Reconstructive Surgery,2010,126(4):1201-1212.DOI:10.1097/prs.0b013e3181ebe391
[15]Romo T III,Reitzen SD.Aesthetic microtia reconstruction with Medpor.Facial Plast Surg2008;24(01):120-128.DOI:10.1055/s-2008-1037453
[16]Romo T III,Morris LG,Reitzen SD,Ghossaini SN,Wazen JJ,Kohan D.Reconstruction of congenital microtia-atresia:outcomes with the Medpor/bone-anchored hearing aid-approach.Ann Plast Surg 2009;62(04):384-389.DOI:10.1097/SAP.0b013e31819fae51
[17]Bosilj D,Arko D,B Gori?ek,et al.Ear Reconstruction Using a Porous Polyethylene Framework and Temporoparietal Fascia Flap[J].Facial Plastic Surgery,2009,25(03):181-189.DOI:10.1055/s-0029-1239448
[18]Helling E R,Okoro S,Kim G,et al.EndoscopeAssisted Temporoparietal Fascia Harvest for Auricular Reconstruction[J].Plastic and Reconstructive Surgery,2008,121(5):1598-1605.DOI:10.1097/prs.0b013e31816a9fb9
[19]Fernandes J R,Driscoll D N.Burn Ear Reconstruction Using Porous Polyethylene Implants and Tissue Expansion[J].Journal of Burn Care&Research,2016,37(4):e348-e352.DOI:10.1097/bcr.0000000000000294
[20]Kim Y S,Yun I S,Chung S.Salvage of Ear Framework Exposure in Total Auricular Reconstruction[J].Annals of Plastic Surgery,2016:1.DOI:10.1097/sap.0000000000000839
[21]Cenzi R,Farina A,Zuccarino L,et al.Clinical Outcome of 285 Medpor Grafts used for Craniofacial Reconstruction[J].Journal of Craniofacial Surgery,2005,16(4):526-530.DOI:10.1097/01.scs.0000168761.46700.dc
[22]Hempel J M,Kn?bl D,Berghaus A,et al.Prospective assessment of quality of life after auricular reconstruction with porous polyethylene.[J].Hno,2014,62(8):564-569.DOI:10.1007/s00106-014-2833-5