| First partThe Three-Dimensional Measurement and Preliminary Analysis of the Symmetry of Facial Soft Tissue of the Patients of Microtia SyndromeObjective: To obtain the scanning and reconstitutive digital model of the facial soft tissue of the patients of Microtia Syndrome by three-dimensional laser scanning technique. Measure and preliminarily analyze the the symmetry of facial soft tissue. Offer theoretical proof for the patients with deformity of facial soft tissue.Methods: A total of 60 cases of patients of unilateral microtia who underwent costal cartilage auricular reconstruction between 2005 and 2008 in external ear center of plastic surgical hospital of Chinese Academy of Medical Sciences. The inclusion criteria of the patients was: 1. Han people.2. aged 12～23 years old.at this time,the development of the facial soft tissue was relatively consummate and the mark point was clear.3.the patient must be unilateral microtia and the ear and facial soft tissue of opposite side were well developed. 4. The patients had no other cephalofacial congenital deformity such as chilopalatognathus.5.the patients had facial soft tissue asymmetry by eye-measurement .6.The patients could match the scanning work. Among all of the patients, 33 of them was male, 27 was female. Obtain the scanning and reconstructive digital model of the facial soft tissue of the patients. Selected 20 mark points in the digital model, and measure and preliminarily analyze the symmetry of facial soft tissue. The content of the measurement was: 1.the measurement of space straight line including the symmetry in X axis, Y axis and Z axis of 20 mark points. 2.The measurement of radian. 3. The measurement of angle. 4. The measurement of area. The available data were analyzed by SPSS 13.0Result: 1. In all of the mark points of the facial soft tissue, the index had significant statistics difference was: the spacing distance from alae nas point to X axis and to Y axis for male; the cheek point to Z axis for male; the cheek point to X axis and to Y axis for female; gonial angle point to X axis ,Y axis and to Z axis for male; gonial angle point to X axis and Y axis for female; tragion point to X axis and Z axis for both male and female. 2. In all of the arc length: all the arc length which were measured had significant statistics difference.3. In the entire angle which was measured, the first, the fourth and the sixth had significant statistics difference.4. In all of the area which were measured,, the index had significant statistics difference was: the area of mandibular area, zygomatic region for male and female.the area of mental region for male.Conclusion: 1. The asymmetric deformity of facial soft tissue of the Patients of Mierotia Syndrome was Three-Dimensional deformity, which was exist in three axial direction.2.the deformity of mandibular area was the most principa appearance.3.the situs which was near the facial midline, like angulus oculi lateralis and alae nas,the degree of deformity was fairly light,the most manifest deformity point was mandible point and tragion point. Second partThe Exploratory Development of the Three-Dimensional Ear Mould in the carving of the auricular branch in reconstruction of the external earObjective: To probe the application of the three-dimensional ear mould in the carving of the auricular branch in the reconstruction of the external ear. Compare the advantage and disadvantage between the three-dimensional ear mould and the x-ray film ear mould in the carving of the auricular branch in the reconstruction of the external ear. Provide new means for auricular reconstructionMethods: A total of 104 cases of patients of unilateral microtia who underwent costal cartilage auricular reconstruction between 2004 and 2008 in external ear center of plastic surgical hospital of Chinese Academy of Medical Sciences. Three-dimensional laser scanning technique and rapid prototyping technology were used to make manufacture three-dimensional mirror imaging ear mould of the uninjured ear before the operation. A follow-up investigation was performed for 84 of the patients. A total of 90cases of patients were followed up with x-ray film ear mould for reconstruction of the external ear. The name, gender, age, and the follow-up time are included in the content of the study. Two sets of the shape and symmetry of the reconstructive auricle were compared by 5 clinicians, and two sets of the Cranioauricular Angle were compared too. The available data were analyzed by SPSS13.0 and Pearson'X~2 test.Result: 1. 84 cases with the three-dimensional ear mould, aged 5～30.5 yearsold, average 10.7 years old, followed-up 0.5～3 years. 90 cases with x-ray film ear mould, aged 5.5～31 years old, average 10.9 years old,followed-up0.5～3.5 years.2. The patients with the three-dimensional ear mould were better than those with x-ray film ear mould in the shape and symmetry of the reconstructive auricle and it showed statistically significant difference(P= 0.0424, P<0.05 ).The patients under 13 years with the three-dimensional ear mould were better than those with x-ray film ear mould in the shape and symmetry of the reconstructive auricle and it showed statistically significant difference(P= 0.0207, P<0.05 ). The patients over 13 years with the three-dimensional ear mould were better than those with x-ray film ear mould in the shape and symmetry of the reconstructive auricle, but it showed no statistically significant difference(P=0.9224, P>0.05 ). 3. The patients with the three-dimensional ear mould were better than those with x-ray film ear mould in the Cranioauricular Angle of the reconstructive auricle and it showed statistically significant difference(P=0.0418, P<0.05 ).The patients under 13 years with the three-dimensional ear mould were better than those with x-ray film ear mould in the Cranioauricular Angle of the reconstructive auricle ,but it showed no statistically significant difference(P=0.3529, P>0.05 ). The patients over 13 years with the three-dimensional ear mould were better than those with x-ray film ear mould in the Cranioauricular Angle of the reconstructive auricle, and it showed statistically significant difference(P=0.0390, P<0.05).Conclusion: 1. Three-dimensional ear mould had more clinical value than the x-ray film ear mould. It was technical progress.2.The patients with the three-dimensional ear mould were better than those with x-ray film ear mould in the shape ,symmetry and Cranioauricular Angle of the reconstructive auricle and it showed statistically significant difference.3. The patients over 13 years with the three-dimensional ear mould were better than those with x-ray film ear mould in the shape and symmetry of the reconstructive auricle, but it showed no statistically significant difference(P=0.9224, P>0.05). The patients under 13 years with the three-dimensional ear mould were better than those with x-ray film ear mould in the Cranioauricular Angle of the reconstructive auricle ,but it showed no statistically significant difference(P=0.3529, P>0.05).
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