Chest Capacity Change in Microtia Patients Receiving Total Auricular Reconstruction with Costal Cartilage Graft: Analysis of 3D Chest CT in 22 Cases

以肋骨移植施行外耳重建手術前後胸腔體積的變化評估

陳信宏(Hsin-Hung Chen) ； 陳潤茺(Zung-Chung Chen) ； 陳國鼎(Philip Kuo-Tin Chen) ； 張北葉(Be-Ye Chang) ； 王超然(Chou-Ran Wang) ； 丁大偉(Ta-Wei Ting)

《臺灣整形外科醫學會雜誌》 22卷3期 (2013/09) Pp. 209-215

摘要

背景：對於先天性小耳畸形的病患來說，使用自體的肋軟骨移植來做外耳重建手術，是目前最廣為接受的重建方式。目的及目標：本研究的目的在於評估胸腔體積在經過擷取肋軟骨手術前後的變化。材料及方法：本研究包含了22位以肋軟骨做為外耳重建手術的病患，肋軟骨的擷取範圍為第六至第九肋骨，在術中盡量保持骨膜的完整性，並在術後將剩餘的肋軟骨回填至取骨區；在術前及術後至少六個月後都接受胸部電腦斷層掃描，及影像重建軟體Mimics 來進行胸腔體積的計算，並藉由左胸及右胸體積的相對係數來比較評估術前術後的變化。結果：胸腔體積在術前及術後並沒有統計上的顯著差異，而在年紀低於18歲的組別，胸腔體積仍有明顯地增長。結論：擷取肋軟骨作為外耳重建是安全且不影響胸腔體積的重建手術方式。

並列摘要

Background:Auricular reconstruction with autologous rib cartilage is currently the most popular method of reconstructing patients with microtia.Aim and Objectives:The purpose of this study is to assess the change in lung capacity before and after costal cartilage harvest in patients receiving total auricular reconstruction.Materials and Methods:Twenty-two patients receiving total auricular reconstruction were enrolled in this prospective study. The 6th-9th ribs were harvested from either the ispilateral or contralateral chest wall with preserving of the perichondrium and residual cartilage chips were put back as free graft after carving. 3D-CT was performed before and more than 6 months after the surgery. Computer software (Mimics) was used to calculate the volume of chest capacity. The preoperative and postoperative analytic index of donor side and contralateral side lung volume were compared.Results:No significant difference was found between the preoperative and postoperative chest capacity. The group younger than eighteen years old had nearly significant increased total volume of chest capacity half year later after surgery.Conclusion:Costal cartilage harvest for auricular reconstruction is safe and does not significantly change the chest capacity at 6 months follow up.

並列關鍵字

rib cartilage graft ； chest capacity ； CT ； auricle reconstruction ； chest volumn