Background: Auricular deformities, specifically prominent ears are relatively frequent. Although the physiologic consequences are negligible, the aesthetic and psychological impact on a child’s self-image can be subs...Background: Auricular deformities, specifically prominent ears are relatively frequent. Although the physiologic consequences are negligible, the aesthetic and psychological impact on a child’s self-image can be substantial. The purpose of our study was to examine the post-operative morbidity of otoplasty, analyse the revision rate and identify, if possible, a gold standard procedure. Methods: Retrospective analysis of the results of 104 operations for correction of prominent ears in 24 months that were performed in one NHSHospitalinLondon,UK. Complications were recorded and analysed. Cases requiring revision were reviewed further, according to technique, seniority of Surgeon and whether a trainee was supervised or not. Results: Of 104 patients, 57 were male and 47 were female. Age ranged from4to 60 years. Peak incidence for the primary operation was identified in the early adolescence for both sexes. Total skeletonisation of the cartilage was used in 26 patients (25%). The anterior scoring technique was used in 76 patients (73%). Cartilage holding sutures were used in 52 patients (50%). Complications were recorded in 32 patients, while 11 patients had more than one complications. There was no significant difference in the complication rate between the most popular methods. (Anterior scoring with or without holding sutures, not including Mustardé type, versus total cartilage skeletonisation technique). Conclusion: The multitude of different approaches indicates that there is not clearly definitive technique for correcting prominent ears. It is preferable that the surgeon is comfortable with multiple techniques (to tailor the correction to each individual patient and deformity).展开更多
目的:系统评价单髁置换术治疗自发性膝关节骨坏死的有效性和翻修率情况.方法:计算机检索Web of Science、Pubmed、EMbase等英文数据库,以及中国知网(CNKI)、万方(WANFANG)、维普(VIP)、中国生物医学文献数据库(CBM)等中文数据库,检索时...目的:系统评价单髁置换术治疗自发性膝关节骨坏死的有效性和翻修率情况.方法:计算机检索Web of Science、Pubmed、EMbase等英文数据库,以及中国知网(CNKI)、万方(WANFANG)、维普(VIP)、中国生物医学文献数据库(CBM)等中文数据库,检索时间均为数据库建立至2018年9月30日.检索单髁置换术治疗膝关节自发性骨坏死的单臂随机对照试验,经文献筛选、提取资料后,采用Stata 15.1软件进行疗效Meta分析.结局指标包括治疗前后视觉模拟评分法(VAS)评分、美国特种外科医院膝关节评分(HSS评分)、关节活动度(ROM)、股骨胫骨角(FTA)以及翻修率,采用随机效应模型分析.结果:初次检索获得文献277篇,按照纳入及排除标准,最终纳入21篇文献,共计703例,Meta分析结果显示,9篇文献报道了治疗前后VAS评分,治疗前VAS评分为7.04分(95%CI=[6.50,7.58],P<0.001,I^2=93.5%);治疗后VAS评分为1.96分(95%CI=[1.39,2.54],P<0.001,I^2=95.2%).10篇文献报道了治疗前后HSS评分,治疗前HSS评分为62.76分(95%CI=[59.00,66.53],P<0.001,I^2=94.5%);治疗后HSS评分为89.68分(95%CI=[86.90,92.45],P<0.001,I^2=95.6%).10篇文献报道了治疗前后ROM,治疗前ROM为112.82°(95%CI=[105.52,120.12],P<0.001,I^2=98.8%);治疗后ROM为119.63°(95%CI=[114.05,125.21],P<0.001,I^2=97.2%).11篇文献报道了手术前后FTA,手术前FTA为179.44°(95%CI=[177.99,180.89],P<0.001,I^2=94.0%);手术后FTA为177.36°(95%CI=[176.85,177.88],P<0.001,I^2=60.3%).21篇文献报道了翻修率,为0.02(95%CI=[0.01,0.05],P=0.01,I^2=46.63%).结论:单髁置换术治疗膝关节自发性骨坏死疗效良好,翻修率低.展开更多
文摘Background: Auricular deformities, specifically prominent ears are relatively frequent. Although the physiologic consequences are negligible, the aesthetic and psychological impact on a child’s self-image can be substantial. The purpose of our study was to examine the post-operative morbidity of otoplasty, analyse the revision rate and identify, if possible, a gold standard procedure. Methods: Retrospective analysis of the results of 104 operations for correction of prominent ears in 24 months that were performed in one NHSHospitalinLondon,UK. Complications were recorded and analysed. Cases requiring revision were reviewed further, according to technique, seniority of Surgeon and whether a trainee was supervised or not. Results: Of 104 patients, 57 were male and 47 were female. Age ranged from4to 60 years. Peak incidence for the primary operation was identified in the early adolescence for both sexes. Total skeletonisation of the cartilage was used in 26 patients (25%). The anterior scoring technique was used in 76 patients (73%). Cartilage holding sutures were used in 52 patients (50%). Complications were recorded in 32 patients, while 11 patients had more than one complications. There was no significant difference in the complication rate between the most popular methods. (Anterior scoring with or without holding sutures, not including Mustardé type, versus total cartilage skeletonisation technique). Conclusion: The multitude of different approaches indicates that there is not clearly definitive technique for correcting prominent ears. It is preferable that the surgeon is comfortable with multiple techniques (to tailor the correction to each individual patient and deformity).
文摘目的:系统评价单髁置换术治疗自发性膝关节骨坏死的有效性和翻修率情况.方法:计算机检索Web of Science、Pubmed、EMbase等英文数据库,以及中国知网(CNKI)、万方(WANFANG)、维普(VIP)、中国生物医学文献数据库(CBM)等中文数据库,检索时间均为数据库建立至2018年9月30日.检索单髁置换术治疗膝关节自发性骨坏死的单臂随机对照试验,经文献筛选、提取资料后,采用Stata 15.1软件进行疗效Meta分析.结局指标包括治疗前后视觉模拟评分法(VAS)评分、美国特种外科医院膝关节评分(HSS评分)、关节活动度(ROM)、股骨胫骨角(FTA)以及翻修率,采用随机效应模型分析.结果:初次检索获得文献277篇,按照纳入及排除标准,最终纳入21篇文献,共计703例,Meta分析结果显示,9篇文献报道了治疗前后VAS评分,治疗前VAS评分为7.04分(95%CI=[6.50,7.58],P<0.001,I^2=93.5%);治疗后VAS评分为1.96分(95%CI=[1.39,2.54],P<0.001,I^2=95.2%).10篇文献报道了治疗前后HSS评分,治疗前HSS评分为62.76分(95%CI=[59.00,66.53],P<0.001,I^2=94.5%);治疗后HSS评分为89.68分(95%CI=[86.90,92.45],P<0.001,I^2=95.6%).10篇文献报道了治疗前后ROM,治疗前ROM为112.82°(95%CI=[105.52,120.12],P<0.001,I^2=98.8%);治疗后ROM为119.63°(95%CI=[114.05,125.21],P<0.001,I^2=97.2%).11篇文献报道了手术前后FTA,手术前FTA为179.44°(95%CI=[177.99,180.89],P<0.001,I^2=94.0%);手术后FTA为177.36°(95%CI=[176.85,177.88],P<0.001,I^2=60.3%).21篇文献报道了翻修率,为0.02(95%CI=[0.01,0.05],P=0.01,I^2=46.63%).结论:单髁置换术治疗膝关节自发性骨坏死疗效良好,翻修率低.
