耳再造术在全耳郭缺损畸形修复中的应用  

Application of auricular reconstruction in repair of whole auricle defect and deformity

作　　者：陈雪莹 刘暾 CHEN Xueying;LIU Tun(the Fourth Department of Plastic Surgery,Plastic Surgery Hospital of Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing,100144)

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：《实用临床医药杂志》2022年第13期55-59,67,共6页Journal of Clinical Medicine in Practice

摘　　要：目的探讨全耳郭缺损畸形修复再造手术的方式、效果和操作要点。方法选取2019年1月—2020年12月先天性无耳畸形及后天性全耳郭缺损畸形患者35例为研究对象,分析其手术方式和术后再造耳外形的美学效果。结果35例患者切口均I期愈合;术后随访显示再造耳形态稳定,结构清晰,外观逼真,位置与健侧耳对称;耳甲腔、三角窝、颅耳角等结构显现良好,患者对再造耳外形满意。结论全耳郭缺损畸形耳再造术中,自体肋软骨移植结合皮肤扩张法或颞浅筋膜瓣法均能取得较好的效果。临床上应充分评估乳突区皮肤情况、发际线位置及肋软骨供区的条件,选择最适宜的手术方式,以获得最佳的耳再造术效果。Objective To explore the methods,effects and operating key points of repair and reconstruction surgeries for whole auricle defectand deformity.Methods Thirty-five patients with congenital auricular malformation and acquired whole auricular defect from January 2019 to December 2020 were selected as study objects,and surgical methods for these patients and the aesthetic effects of reconstructed ears after operation were analyzed.Results All the incisions of 35 patients healed in the first stage;the postoperative follow up results showed that the shape of reconstructed ear was stable,the structure was clear,the appearance was lifelike,the position was symmetrical with the ear in healthy side;the structures such as auricular concha cavity,triangular fossa and cranial auricular angle were well displayed,and the patients were satisfied with the shape of the reconstructed ear.Conclusion In the reconstruction of deformity with whole auricle defect,autologous costal cartilage transplantation combined with skin expansion or superficial temporal fascia flap can achieve good effect.In clinic,the skin condition of mastoid region,the position of hairline and the conditions of costal cartilage donor area should be fully evaluated,and the most appropriate surgical method should be closed to obtain the best effect of auricular reconstruction.

关 键 词：先天性无耳畸形 获得性全耳郭缺损 耳郭再造 自体肋软骨移植 皮肤扩张法 乳突区皮肤 

分 类 号：R764.7[医药卫生—耳鼻咽喉科] R622[医药卫生—临床医学]