耳后超薄斜行筋膜瓣在Nagata耳再造二期中的应用  

Application of ultra-thin oblique posterosuperior auricular fascial flap in the second stage of Nagata microtia reconstruction

作　　者：李钢[1] 张如鸿 杨丽[1] 朱旭冉 刘月丽[1] 江艳 Li Gang;Zhang Ruhong;Yang Li;Zhu Xuran;Liu Yueli;Jiang Yan(Department of Medical Cosmetology,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China;Department of Plastic surgery,Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200023,China)

机构地区：[1]郑州大学第二附属医院医疗美容科,450014 [2]上海交通大学第九人民医院整形外科,200023

出　　处：《中华整形外科杂志》2020年第1期53-55,共3页Chinese Journal of Plastic Surgery

摘　　要：目的探讨耳后超薄斜行筋膜瓣在Nagata耳再造二期中的应用效果。方法选取郑州大学第二附属医院医疗美容科2015年11月至2018年11月收治的54例先天性小耳畸形患者为研究对象,男42例,女12例,年龄8~31岁。一期行肋软骨耳支架植入,二期采用耳后超薄斜行筋膜瓣包裹支架加游离植皮,行耳再造手术,重建颅耳角,术后定期随访。结果54例中48例植皮完全成活,其中8例术后有积血,经换药后创面愈合。术后患者均获6~24个月随访,患侧颅耳角形态、结构良好,皮肤颜色与健侧接近。结论在Nagata耳再造二期手术中,耳后超薄斜行筋膜瓣血供可靠,创伤小,耳后不臃肿,手术效果好,是包裹耳后支架的良好选择。Objective To investigate the effect and safety of ultra-thin oblique posterosuperior auricular fascial flap in the second stage of ear reconstruction.Methods Fifty-six cases with congenital microtia treated in The Second Affiliated Hospital of Zhengzhou University Medical Cosmetology Department from November 2015 to November 2018 were selected as the research objects.In the first stage,the costal cartilage ear stent was implanted,and in the second stage.The ultra-thin posterior oblique fascia flap was used to cover the stent.And the cranioauricular angle was reconstructed by free skin grafting.Results 48 cases of the 54 cases completely survived,and 8 cases had hemorrhage after operation.The wounds were healed after dressing change.The postoperative cranioauricular angle was close to the healthy side.Conclusions In the second stage of ear reconstruction,the retroauricular ultra-thin fascial flap method has reliable blood supply,small wound,unswollen reconstructed ears,and good outcome.It is a good choice for covering the ear framework.

关 键 词：耳廓再造术 筋膜瓣 小耳畸形 

分 类 号：R76[医药卫生—耳鼻咽喉科]