目的:探讨二期法耳廓再造同期置入骨桥治疗先天性小耳畸形的临床效果。方法:回顾性分析2017年6月至2019年8月中国医学科学院整形外科医院与首都医科大学附属北京同仁医院合作收治的52例先天性小耳畸形伴听力功能障碍患儿的临床资料，男35例，女17例，年龄6～12岁。所有患者均完成二期手术：一期行Nagata法耳廓支架植入术；二期行耳颅角成形及骨桥置入术。术后进行随访，通过耳廓形态和听力评估等评价手术效果，耳廓形态由患儿本人及家属进行主观评价，听力评估主要对比患者术前和术后的纯音测听结果及言语识别率。应用SPSS 19.0软件进行数据分析，计量资料以n ±n s表示，采用配对样本n t检验进行比较，n P<0.05为差异有统计学意义。n 结果:术后随访3～10个月，平均6个月，52例中47例(90.4%)患者再造耳的空间三维结构及局部亚单位形态均令人满意；4例出现耳后瘢痕明显增生或瘢痕疙瘩。术后3周纯音测听检查结果显示，术后气导阈值平均为(38.8±7.2) dB HL，比术前的(72.4±9.0) dB HL下降了(33.6±6.2) dB HL，差异有统计学意义(n t＝38.13，n P<0.001)；言语识别率术前平均为31.9%，术后平均为85.0%，提高了24%～67%，术前后比较差异有统计学意义(n t＝-40.15，n P<0.001)。n 结论:耳廓再造与骨桥置入同期进行，使先天性小耳畸形患儿在获得良好耳廓形态的同时，听力亦得到明显改善。“,”Objective:To investigate the clinical effect of two-stage auricular reconstruction combined with Bonebridge implantation in the treatment of congenital microtia.Methods:The clinical data of 52 patients with congenital microtia and hearing impairment were retrospectively analyzed. The patients were admitted to the Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Beijing Tongren Hospital Affiliated to Capital Medical University from June 2017 to August 2019. There were 35 males and 17 females, aged 6-12 years. All patients received the two-stage surgery. The first stage surgery was Nagata’s technique described as follows: rib cartilage harvest and framework implantation. The second stage surgery combined auricle elevation with Bonebridge implantation. Postoperative follow-up was conducted to evaluate the effect of the operation through auricular morphology and auditory evaluation. The auricular morphology was subjectively evaluated by the patient and the patient’s family members. The audiometric evaluation mainly included the comparisons of the pure tone audiometry results and speech recognition rate of the patients before and after the operation. SPSS 19.0 software was used for data analysis. The measurement data were showed as Mean±SD, and the comparison results were analyzed by paired n t test. n P<0.05 was considered statistically significant.n Results:After follow-ups of 3-10 months, with an average of 6 months, the spatial three-dimensional structure and local subunit morphology of the reconstructed ears were satisfactory in 47 patients (90.4%). Four patients had obvious scarring or keloid in retroauricular region, which affected the aesthetic outcome. The results of pure tone audiometry at 3 weeks after surgery showed that the postoperative air conduction threshold was (38.8±7.2) dB HL, which decreased by (33.6±6.2) dB HL compared to that before surgery (72.4±9.0) dB HL, and the difference was statistically significant (n t=38.13, n P<0.001). The speech recognition rate was increased by 24%-67%, which was improved from 31.9% before surgery to 85.0% after surgery. The difference was statistically significant (n t=-40.15, n P<0.001).n Conclusions:Auricular reconstruction and Bonebridge implantation were carried out in one stage of surgery, so that the patients with congenital microtia could obtain good auricular morphology and improve their hearing significantly.