耳再造术后远期并发症的临床管理策略与研究进展

Clinical Management Strategies and Research Advances in Long-Term Complications after Auricular Reconstruction

摘要: 目的：耳再造术广泛应用于小耳畸形、外伤性缺损及肿瘤术后耳廓重建，虽早期并发症控制已有进展，但远期并发问题仍显著，亟需系统梳理其发生机制与管理对策。方法：本文通过回顾近年中英文文献，系统归纳耳再造术后远期并发症的临床类型、发病机制、防治策略，并结合不同术式(自体肋软骨、Medpor、3D打印)特点展开对比分析。同时，关注组织工程、AI辅助评估、多中心数据库等领域的新兴技术进展。结果：耳再造术后远期并发症包括支架外露、耳廓变形、对称性差、软组织退变及慢性感染等，其发生率受多因素交互影响，严重制约术后满意度与长期疗效。结论：提高耳再造术远期效果应贯穿术前风险评估、术中关键控制与术后个体化随访全流程。建议构建标准化并发症评估体系，推动多学科协作干预与个体化重建策略的临床转化，以实现长期稳定与功能兼顾的重建目标。

Abstract: Objective: Auricular reconstruction is a critical component of facial reconstructive surgery, commonly applied in congenital microtia, traumatic auricular defects, and post-oncologic auricular reconstruction. Despite the decline in early postoperative complications, long-term complications remain a major concern and warrant systematic evaluation. Methods: This review synthesizes recent literature on the classification, pathogenesis, and management strategies of long-term complications following auricular reconstruction using autologous costal cartilage, Medpor, and 3D-printed scaffolds. It further discusses advances in tissue engineering, artificial intelligence (AI)-assisted symmetry assessment, and multicenter data platforms. Results: Long-term complications—such as framework exposure, auricular deformation, asymmetry, soft tissue degeneration, and chronic infection—are multifactorial and continue to impair postoperative aesthetic and functional outcomes. Conclusion: Optimizing long-term outcomes of auricular reconstruction necessitates integrated approaches spanning preoperative risk stratification, intraoperative technique refinement, and personalized postoperative surveillance. Standardized evaluation frameworks, interdisciplinary collaboration, and technological innovation are essential for achieving durable and patient-centered reconstructive results.