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Funktionelle und ästhetische Rehabilitation der Mikrotie bei Kindern und Jugendlichen

Functional and aesthetic rehabilitation of microtia in children and adolescents

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An Erratum to this article was published on 01 April 2014

Zusammenfassung

Hintergrund

Die Mikrotie geht mit starker funktioneller und ästhetischer Beeinträchtigung einher. Traditionell wird die Ohrmuschel häufig mit Rippenknorpeltransplantaten rekonstruiert, was jedoch mit einigen z. T. erheblichen Nachteilen verbunden ist. Die Autoren verfolgen hingegen seit Jahren mit gutem Erfolg die Ohrmuschelrekonstruktion mit Implantaten aus porösem Polyethylen, wodurch einige dieser Nachteile umgangen werden. Ein besonderer Gewinn entsteht für die Betroffenen bei simultaner Hörverbesserung durch Implantation aktiver Mittelohrprothesen.

Methoden

Die Autoren stellen ihr chirurgisches Konzept vor, das eine funktionelle und ästhetische Rehabilitation der Mikrotie bei Kindern und Jugendlichen in nur einer Operation ermöglicht. Im betreffenden Patientengut wurden prä- und postoperativ audiometrische Messungen in Ruhe und im Störgeräusch durchgeführt sowie die gesundheitsbezogene Lebensqualität mithilfe eines validierten Fragebogens evaluiert.

Ergebnisse

Bei allen Patienten stellte sich postoperativ sowohl in Ruhe als auch im Störgeräusch ein deutlicher Hörgewinn ein. Die Evaluation der gesundheitsbezogenen Lebensqualität zeigte einen signifikanten Nutzen der Intervention.

Schlussfolgerungen

Die funktionelle und ästhetische Rehabilitation der Mikrotie mit aktiven Mittelohrimplantaten und einer Ohrmuschelrekonstruktion mit porösem Polyethylen zeigt mit hoher Zuverlässigkeit gute Langzeitergebnisse und kann die gesundheitsbezogene Lebensqualität betroffener Kinder und Jugendlicher steigern. Wesentlicher Vorteil dieses Konzepts ist die Möglichkeit eines einzeitigen Vorgehens.

Abstract

Background

Microtia leads to a severe functional and aesthetic handicap. Traditionally, the auricle is often reconstructed with cartilage transplants, which is, however, associated with some partially substantial disadvantages. The authors have instead used implants of porous polyethylene for successful ear reconstruction for years, thus, avoiding some of these disadvantages. A significant benefit for the patient is achieved by simultaneous hearing rehabilitation by the implantation of active middle ear prostheses.

Methods

The authors present their surgical concept which allows functional and aesthetic rehabilitation of microtia in children and adolescents in a single operation. In the respective patient collective, audiometric measurements in quiet and noisy environments were conducted pre- and postoperatively, and health-related quality of life was determined using a validated questionnaire.

Results

All patients experienced a substantial hearing gain both in quiet and noisy environments. The evaluation of health-related quality of life showed a significant benefit from the intervention.

Conclusion

Functional and aesthetic rehabilitation of microtia with active middle ear implants and ear reconstruction using porous polyethylene leads to good and reliable long-term results and can increase the health-related quality of life of affected children and adolescents. The main advantage of this concept is the possibility of a single procedure.

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Interessenkonflikt

Dr. Hempel erhielt Reisekostenerstattungen für wissenschaftliche Fachkongresse durch die Firma Med-El. Prof. Dr. Berghaus und Dr. Braun: jeweils kein Interessenkonflikt.

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Authors and Affiliations

  1. Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland

    J.M. Hempel, T. Braun &  A. Berghaus

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  1. J.M. Hempel
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  2. T. Braun
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  3. A. Berghaus
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Correspondence to A. Berghaus.

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Hempel, J., Braun, T. & Berghaus, A. Funktionelle und ästhetische Rehabilitation der Mikrotie bei Kindern und Jugendlichen. HNO 61, 655–661 (2013). https://doi.org/10.1007/s00106-013-2694-3

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