Abstract：
OBJECTIVE: Unilateral costal cartilage harvesting (UCCH) for auricle reconstruction in children tends to cause thoracic deformities. Therefore, our study aimed to develop a novel bilateral costal cartilage harvesting (BCCH) method to prevent and reduce thoracic deformities.
METHODS: Patients with unilateral microtia who underwent either UCCH (n = 50) or BCCH (n = 46) were enrolled in this study. The grafts for the BCCH group were harvested from the 6th costal cartilage of the ipsilateral hemithorax and the 7th and 8th cartilage from the other hemithorax. Computed tomography and physical examination were performed to identify any physical deformities in the chest contours post-surgery. The cosmetic appearance of the thoracic scars post-surgery was evaluated using the Scar Cosmesis Assessment and Rating Scale (SCAR) and Visual Analogue Scales (VAS cosmetic). The numerical rating scale (NRS) was used to quantify the pain in donor sites. The reconstructed ears were assessed during the follow-up period.
RESULTS: None of the patients in the BCCH group developed thoracic deformities, while 16 patients within the UCCH group developed mild (n = 12) or severe (n = 4) thoracic deformities (p < 0.001). The SCAR (3.09 vs. 2.92, p = 0.580) and VAS scores (0.96 vs. 0.90, p = 0.813) did not differ significantly between the two groups. For both treatment arms, the NRS scores were highest on the first-day post-surgery and gradually dropped over the 10 days. No significant differences were found in the NRS scores and the aesthetic outcomes of the reconstructed ears between the two groups.
CONCLUSIONS: The BCCH method effectively reduced the incidence of thoracic deformity at the donor site without increasing postoperative pain and cosmetic concerns for patients. It could be used clinically to improve patient outcomes of costal cartilage grafts.
METHODS: 4 Laryngoscope, 134:3572-3580, 2024.
METHODS: Patients with unilateral microtia who underwent either UCCH (n = 50) or BCCH (n = 46) were enrolled in this study. The grafts for the BCCH group were harvested from the 6th costal cartilage of the ipsilateral hemithorax and the 7th and 8th cartilage from the other hemithorax. Computed tomography and physical examination were performed to identify any physical deformities in the chest contours post-surgery. The cosmetic appearance of the thoracic scars post-surgery was evaluated using the Scar Cosmesis Assessment and Rating Scale (SCAR) and Visual Analogue Scales (VAS cosmetic). The numerical rating scale (NRS) was used to quantify the pain in donor sites. The reconstructed ears were assessed during the follow-up period.
RESULTS: None of the patients in the BCCH group developed thoracic deformities, while 16 patients within the UCCH group developed mild (n = 12) or severe (n = 4) thoracic deformities (p < 0.001). The SCAR (3.09 vs. 2.92, p = 0.580) and VAS scores (0.96 vs. 0.90, p = 0.813) did not differ significantly between the two groups. For both treatment arms, the NRS scores were highest on the first-day post-surgery and gradually dropped over the 10 days. No significant differences were found in the NRS scores and the aesthetic outcomes of the reconstructed ears between the two groups.
CONCLUSIONS: The BCCH method effectively reduced the incidence of thoracic deformity at the donor site without increasing postoperative pain and cosmetic concerns for patients. It could be used clinically to improve patient outcomes of costal cartilage grafts.
METHODS: 4 Laryngoscope, 134:3572-3580, 2024.
摘要：
目的：儿童耳廓重建的单侧肋软骨获取（UCCH）往往会导致胸部畸形。因此,我们的研究旨在开发一种新的双侧肋软骨获取（BCCH）方法，以预防和减少胸部畸形。
方法：接受UCCH（n=50）或BCCH（n=46）的单侧小耳畸形患者被纳入本研究。BCCH组的移植物是从同侧半胸部的第6肋软骨和其他半胸部的第7和第8软骨中收获的。进行计算机断层扫描和体格检查以确定手术后胸部轮廓中的任何身体畸形。手术后胸廓疤痕的外观使用疤痕压迫评估和评定量表（SCAR）和视觉模拟量表（VAS化妆品）进行评估。使用数字评定量表(NRS)来量化供体部位的疼痛。在随访期间评估重建的耳朵。
结果：BCCH组没有患者出现胸廓畸形，UCCH组中有16例患者出现轻度（n=12）或重度（n=4）胸畸形（p<0.001）。SCAR（3.09vs.2.92，p=0.580）和VAS评分（0.96与0.90，p=0.813）两组之间没有显着差异。对于两个治疗臂，NRS评分在术后第一天最高,在10天内逐渐下降.两组的NRS评分和重建耳朵的美学效果无明显差异。
结论：BCCH方法有效地降低了供体部位胸廓畸形的发生率，而不会增加患者的术后疼痛和美容问题。它可以在临床上用于改善肋软骨移植物的患者预后。
方法：4喉镜，2024.
方法：接受UCCH（n=50）或BCCH（n=46）的单侧小耳畸形患者被纳入本研究。BCCH组的移植物是从同侧半胸部的第6肋软骨和其他半胸部的第7和第8软骨中收获的。进行计算机断层扫描和体格检查以确定手术后胸部轮廓中的任何身体畸形。手术后胸廓疤痕的外观使用疤痕压迫评估和评定量表（SCAR）和视觉模拟量表（VAS化妆品）进行评估。使用数字评定量表(NRS)来量化供体部位的疼痛。在随访期间评估重建的耳朵。
结果：BCCH组没有患者出现胸廓畸形，UCCH组中有16例患者出现轻度（n=12）或重度（n=4）胸畸形（p<0.001）。SCAR（3.09vs.2.92，p=0.580）和VAS评分（0.96与0.90，p=0.813）两组之间没有显着差异。对于两个治疗臂，NRS评分在术后第一天最高,在10天内逐渐下降.两组的NRS评分和重建耳朵的美学效果无明显差异。
结论：BCCH方法有效地降低了供体部位胸廓畸形的发生率，而不会增加患者的术后疼痛和美容问题。它可以在临床上用于改善肋软骨移植物的患者预后。
方法：4喉镜，2024.
