扩张皮瓣加筋膜瓣“两瓣法”在小耳畸形患者耳郭再造中的应用  

Application of expanded skin flaps and fascial flaps (the two flaps method) in ear reconstruction for patients with microtiag

作　　者：薄琳[1] 刘新刚[1] 刘玉红[1] 苏法仁[1] BO Lin;LIU Xingang;LIU Yuhong;SU Faren(Department of Auricle Reconstruction Center,Chinese Armed Peoples Police Force,Shandong Provincial Corps Hospital,Jinan 250014,Shandong,China)

机构地区：[1]武警山东总队医院中国武警外耳再造中心

出　　处：《山东大学耳鼻喉眼学报》2019年第6期49-51,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨带蒂扩张皮瓣加带蒂筋膜瓣“两瓣法”在先天性小耳畸形患者耳郭再造中的应用及效果。方法总结2012年1月至2018年1月期间712例(756耳)先天性小耳畸形患者,全部采用“两瓣法”行耳郭再造。结果术后随访1~6年,712例(756耳),其中15例(15耳)术后出现钢丝外露,经及时处理,拆除钢丝后治愈;10例术后出现再造耳郭皮下血肿,经更换负压引流管,引流通畅后,血肿消失;3例因术后患者保护不当,再造耳郭受压、碰伤导致软骨支架外露,经局部皮肤拉拢缝合,带蒂筋膜瓣覆盖表面植皮,及时处理后治愈。全部病例最终效果均满意,再造耳郭的大小、形态、位置与健耳对称,再造耳郭皮肤颜色正常,耳郭软骨支架无外露及吸收,细微凹凸结构显示清晰。结论“两瓣法”耳郭再造效果确切,术后并发症少,是先天性小耳畸形行耳郭再造较好的方法。Objective To discuss the application and effect of ear reconstruction with expanded skin flaps and fascial flaps(the two flaps method),in congenital microtia.Methods The study included 712 cases(756 ears)of congenital microtia from January 2012 to January 2018,all reconstructed with the two flaps method.Results All cases were followed-up for 1 to 6 years.Among them,15 cases(15 ears)had steel wire exposure after the operation,which was resolved after removing the steel wire over time.Ten cases had subcutaneous hematoma of the reconstructed auricle after the operation,which disappeared after replacing the negative pressure drainage tube.Three cases had exposed cartilage scaffold due to improper protection of the reconstructed auricle,which was sutured by local skin and covered with pedicled fascia flaps.Patients were cured after timely treatment.The size,shape,and location of the reconstructed auricles were basically symmetrical with the healthy ears.The reconstructed auricle skin was normal in color,the auricle cartilage scaffold was not exposed or absorbed,and the fine concave and convex structure was clear.Conclusion The two flaps ear reconstruction is a better method for the treatment of congenital microtia because of its superior result and fewer complications.

关 键 词：两瓣法 先天性小耳畸形 耳郭再造 

分 类 号：R764.7[医药卫生—耳鼻咽喉科]