摘要
目的 探讨耳后扩张皮瓣、耳后筋膜瓣两瓣法包裹自体肋软骨支架再造先天性小耳畸形的方法.方法 手术分为耳后扩张器置入,耳后扩张皮瓣、耳后筋膜瓣两瓣包裹自体肋软骨支架再造外耳基本形态和耳屏重建、耳甲腔加深3个步骤.自2000年10月至2010年12月,对1026例先天性小耳畸形患者行两瓣法耳郭再造术,其中双侧先天性小耳畸形者72例,再造耳共1098只.结果 1026例患者中,血肿14例,切口裂开8例,扩张皮肤坏死12例,感染1例,软骨支架外露11例.822例获随访6个月至4年,再造耳形态结构稳定,耳轮、耳屏均良好显现,耳甲腔深,颅耳角良好,大部分与健侧对称.795例再造耳对耳轮、三角凹和舟状凹显现明显,27例显现不够.结论 此方法 可一次覆盖肋软骨耳支架,并可获得具有细微结构、稳定竖立的再造耳,是先天性小耳畸形理想的治疗方法.但存在治疗周期长、并发症发生概率增多、手术创伤较大、瘢痕略重的缺点.
Objective To explore the reconstruction of congenital microtia by wrapping autogenous costal cartilage framework with retroauricular expanded flap and retroauricular fascia flap. Methods Microtia reconstruction was generally completed by 3 steps. Firstly, tissue expander was inserted subcutaneously into retroauricular mastoid region, then the retroauricular expanded flap and fascial flap were used to wrap autogenous costal cartilage framework to construct external shape, and finally, tragus was reconstructed and cavity of auricular concha was deepened. From October 2000 to December 2010, 1098 ears from 1026 congenital microtia （72 cases with bilateral congenital microtia） were treated with the method mentioned above. Results Among the postoperative 1026 cases, 14 cases were with hematoma, 8 cases with disruption of wound, 12 cases with expanded skin necrosis, 1 case with infection and 11 cases with exposure of cartilage framework. Of 1026, 822 cases were followed up for 6 months to 4 years, which were satisfied with stable structure of reconstructed helix, tragus, deepened cavity of auricular concha and fine cranioauricular angle which were symmetry to opposite normal ears, 795 showed obviously antihelix, triangular fossa and scapha while the other 27 were not obvious. Conclusion The technique is an ideal method to treat the congenital microtia by covering the cartilage ear framework at single step, obtaining erect reconstructed auricle with fine structure. On the other hand, disadvantages of the technique are relative higher ratio of complications, longer treatment cycle, larger surgical trauma and slightly severe scar.
出处
《中国美容整形外科杂志》
CAS
2012年第4期196-200,共5页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
耳郭再造
肋软骨
耳后扩张皮瓣
耳后筋膜瓣
Auricular reconstruction
Costal cartilage
Retroauricular expanded flap
Retroauricular fascia flap
