耳廓复合组织瓣的三种术式修复鼻翼缺损的临床评价  

Alar reconstruction by different methods of composite ear transplantation: a clinical evaluation

作　　者：许礼根[1] 施耀明[1] 钱云良[1] 濮哲铭[1] 

机构地区：[1]上海第二医科大学第九人民医院整复外科,上海200011

出　　处：《中华医学美学美容杂志》2004年第5期257-259,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的　根据患者鼻翼缺损的形态、自身条件和面容 ,选择一种简易、理想的耳廓复合组织瓣术式 ,使修复的鼻翼饱满 ,鼻孔对称 ,从而获得比较完美的鼻形。方法　通过对 5年来 32例鼻翼缺损修复中的 2 6例进行随访 ,比较不同耳廓复合组织移植术式的优缺点、术中注意点 ,找出各种鼻翼缺损的合适术式。结果　 3种耳廓复合组织瓣术式修复鼻翼缺损的随访优良率 ,差异不具有显著性意义。结论　 3种耳廓复合组织瓣术式修复鼻翼缺损外形均良好 ,重要的是选择好手术适应证。游离耳廓复合组织瓣修复鼻翼缺损术式简便易行 ,面部不增加新的瘢痕 ;眶上动脉供血的反流轴型岛状耳廓复合组织瓣修复鼻翼缺损的术式 ,修复鼻翼缺损范围大 ,但受血管条件限制 ;吻合血管的游离耳廓复合组织瓣修复鼻翼缺损 ,修复后鼻槛及外侧壁形态好 ,但操作难度大。Objective To select a simple and suitable operation metho d of composite ear transplantation according to the feature of alar defection an d personal characteristics, which can lead to a perfect reconstructional result with plump ala and symmetric nostril. Methods Evaluation standa rds, practical situation, attentions in operation, advantages and disadvantages of 3 methods of composite ear transplantation were determined from the follow-u p results in 26 out of 32 alar reconstruction cases in recent 5 years. R esults No obvious difference was found out of the results of the 3 meth ods of composite ear transplantation. Conclusions All the 3 met hods of composite ear transplantation are effective. Composite ear graft is simp le, with no further scar formation on face. Refluent axil ear flap pedicled by s upraorbital artery is suitable to bigger defection but the transplantation is re stricted by vessel condition. Composite ear flap transplantation with vessels an astomoses can reach a satisfactory result but the operation is complex. It is im portant to get a satisfactory reconstructive result that a suitable method is se lected according to the features of alar defection and personal characteristics.

关 键 词：耳廓复合组织瓣 修复 鼻翼缺损 手术方式 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]