烧伤性耳部畸形的矫正  

Correction of post-burn auricular deformities

作　　者：张晨[1] 杨薇[1] 刘洋子 林中梅[1] 王洁晴[1] ZHANG Chen;YANG Wei;LIU Yang-zi;LIN Zhong-mei;WANG Jie-qing(Department of Plmtic and Aesthcfic Surgery,Xinhua Hospital Affiliated to Dalian University,Dalum 116021,China)

机构地区：[1]大连大学附属新华医院整形外科,辽宁大连116021

出　　处：《中国美容整形外科杂志》2021年第4期198-200,213,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨烧伤性耳部畸形的特点及修复方法。方法回顾2010—2020年大连大学附属新华医院整形外科收治的28例烧伤性耳部畸形患者的临床资料。对耳部烧伤畸形的部位及修复方法进行总结。所有患者均合并头皮、耳后、面部及颈部烧伤,其中累及耳轮、耳舟及耳垂者4例,累及耳轮下部及耳垂者15例,单纯累及耳垂9例。结果28例患者移植的皮瓣、皮肤均100%成活。无软骨支架外露发生。对耳轮缺失者全部采用皮管法修复,移植的皮管皮瓣全部成活。所有患者获随访1~5年,2例局部瘢痕,2例再造耳轮耳垂回缩,余24例患者均满意。结论烧伤性耳畸形以耳部周边结构缺失为主。修复耳郭大部结构缺失需要邻近皮肤扩张皮瓣或颞浅筋膜瓣结合肋软骨支架修复;部分耳轮或耳垂缺失可采用皮管法或邻近皮瓣转移完成畸形修复。皮管皮瓣联合耳软骨移植可有效地避免再造耳轮耳垂回缩。Objective To explore the characteristics and corrective methods of post-burn auricular deformities.Methods The clinical data of 28 patients with post-burn auricular deformities treated in our department from 2010 to 2020 were reviewed.The positions of post-burn auricular deformities and the corresponding repair methods were summarized.All patients had comorbidities such as burnof scalp,retroauricular area,faceand neck.There were 4 cases involved in helix,scapha and earlobe,15 cases involved in earlobe and nearby part of helix,9 casesonlyinvolved in earlobe.Results The transplanted flap and skin were survived in 28 patients.No exposure of cartilage framework was found.For patients with defects helix,the skin tube was the main method for reconstruction.All patients were followed-up for 1 to 5 years,there were 2 cases of local scar and 2 cases of retraction of reconstructed helix and earlobe.The remaining24 patients were satisfied with the results of treatment.Conclusion Most auricular defects after burn happened on the exposed marginal areas of ear.In the repair of most structure loss of the auricle,the adjacent skin expanded flap or superficial temporal fascia flap combined with costal cartilage framework is needed.For partial helix or earlobe defects,the skin tube method or adjacent flap transfer can be used for reconstruction.The tube flap combined with cartilage transplantation can effectively avoid the retraction of reconstructed helix and earlobe.

关 键 词：耳畸形 烧伤 再造术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]