残耳逆行转位在低位残耳患者耳再造中的应用  

Application of retrograde transposition of the remnant earlobe in patients with low-set microtia

作　　者：李志斌[1] 程琳[1] 胡金天[1] 周栩[1] 刘暾[1] 章庆国[1] 

机构地区：[1]中国医学科学院北京协和医学院整形外科医院整形四科,北京100144

出　　处：《中国美容整形外科杂志》2016年第4期196-198,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨先天性小耳畸形合并低位残耳患者耳垂的处理方法。方法自2010年10月至2014年6月,对42例小耳畸形合并半侧颜面短小症耳垂低位的患者,采用扩张法或者改良Nagata方法进行外耳再造术。由于残耳组织较健侧耳位置低,其处理采用逆行耳垂转位的方法,即以残耳上部为蒂,将残耳中下部掀起形成耳垂皮瓣,将耳垂皮瓣向上向后旋转,与耳后乳突区皮瓣相衔接,覆盖软骨支架的下端,形成耳垂和耳轮的一部分。切取残耳的创面采用直接缝合方法。结果 42例患者残耳逆行移位后,耳垂血运良好,再造耳耳垂存活良好,无破溃;所有患者获随访2个月至2年,再造耳与健侧耳位置基本对称,利用残耳逆行转位形成的耳垂形态自然。结论残耳逆行移位行耳垂再造,对于半侧颜面短小残耳位置明显低于健侧者,是一种安全有效的处理方法。Objective To discuss the method of lobule transposition of congenital microtia patients with lowset remnant ears. Methods From October 2010 to June 2014, 42 microtia with hemifacial microsomia and low-set lobe were treated by auricle reconstruction with expansion or the modified Nagata method. Due to the fact that the location of the remnant ear was lower than the contralateral normal ear, the superior part of the remnant ear was taken as the pedicle and the inferior parts of the remnant ear were lifted to form the lobular flap, Then the flap was rotated up and backward to cover the inferior extremity of the framework and to form the inferior part of the helix and lobe. The wound was closed by direct suture. Results The blood supply of the retrograde-transposed lobe on 42 patients was good and the reconstructed lobules all survived well after surgery without necrosis. After 2 months to 2 years follow-up, all patients were satisfied with aesthetically natural earlobes and the location of the reconstructed ear was symmetrical to the contralateral one. Conclusion The retrograde transposition technique of the remnant ear in low- set microtia reconstruction combined with HMF is very effective and reliable.

关 键 词：耳再造 低位残耳 逆行转位 半侧颜面短小 耳垂 

分 类 号：R764.9[医药卫生—耳鼻咽喉科] R622[医药卫生—临床医学]