利用自体肋软骨两期修复部分耳廓缺损  

Two-stage Repair of Partial Auricular Defects with Autogenous Costal Cartilage

作　　者：李晶晶 胡金天 王冰清 王悦 钱瑾 刘暾 LI Jingjing;HU Jintian;WANG Bingqing;WANG Yue;QIAN Jin;LIU Tun(Department No.4,Hospital of Plastic Surgery,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing,100144,China)

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：《中华耳科学杂志》2020年第3期498-501,共4页Chinese Journal of Otology

摘　　要：目的探索一种利用自体肋软骨二期完成部分耳廓全层缺损的修复方法,以期获得更好的再造耳廓形态。方法本组共收治15例耳廓部分缺损患者(缺损面积1.5cm×4cm-2.5cm×6cm),一期手术参照Brent全耳再造的方法,以肋软骨为支架修复耳廓缺损部位,用耳后-乳突区舌形皮瓣覆盖支架。二期将耳支架及其深面的筋膜组织一并掀起,耳后、乳突区创面植中厚皮片,构建耳颅角。结果15例患者切口均一期愈合。患者术后随访2-48个月,再造耳廓基本亚单位存在,形态良好,耳颅角清晰,无明显局部皮肤颜色质地差异。结论对于较大范围的部分耳廓全层缺损,自体肋软骨两期修复部分耳廓缺损安全有效,且可以保证好的再造耳廓形态。Objective To report outcomes of staged surgical repair of large auricular defects with autogenous costal cartilage.Methods Fifteen patients with partial auricular defect(1.5×4 cm-2.5×6 cm)were included in the study.The first stage involved repair of auricle defect with costal cartilage(the Brent method)implanted under the skin in the retroauricular mastoid area.In the second stage,retroauricular fascia flap was lifted together with the reconstructed auricle and exposed fascia surface was covered with skin graft to create the cranioauricular sulcus and complete the reconstruction.Results The patients were followed up for 2-48 months with satisfactory result showing reconstructed helix,antihelix,scapha and auricular concha with similar color and desirable details as the contralateral ear.Conclusion Two-stage repair with autogenous costal cartilage is an effective treatment for large partial auricular defects with satisfacctory outcomes.

关 键 词：耳廓缺损 肋软骨 耳廓再造 耳再造 

分 类 号：R764[医药卫生—耳鼻咽喉科]