耳后带蒂皮瓣在修复耳廓前部良性肿瘤术后皮肤缺损的临床应用  

Clinical application of postauricular pedicle flap for repairing postoperative skin defects caused by benign preauricular tumors

作　　者：陈文文 胡春玖[1] 陈惟虎[1] 林忠明[1] 毕永华[1] 胡联国[1] CHEN Wenwen;HU Chunjiu;CHEN Weihu;LIN Zhongming;BI Yonghua;HU Lianguo(Department of Otorhinolaryngology Head and Neck Surgery,Tongling People's Hospital,Tongling,Anhui,244000,China)

机构地区：[1]安徽省铜陵市人民医院耳鼻咽喉头颈外科,244000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第4期255-257,282,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨耳后带蒂皮瓣在修复耳廓前部良性肿瘤术后皮肤缺损中的临床疗效。方法应用耳后带蒂皮瓣修复耳廓前部良性肿瘤所致术后皮肤缺损21例,均为单侧耳发病。手术步骤:切除耳廓前部肿瘤后,以耳后沟为标记,在耳廓前部皮肤缺损的同一位置水平选择耳后皮瓣,分别取2/3皮瓣大小在乳突部皮肤表面,1/3皮瓣大小在耳廓背面皮肤,从耳廓术后缺损的中央近端内侧部分切除约1.0cm×0.6cm的软骨,用作隧道。通过隧道将耳后皮瓣旋转90°至180°,转至前部皮肤软组织缺损处,并将皮瓣间断缝合在耳廓前部,与创面皮肤对齐。观察指标:术后观察皮瓣颜色、切口有无裂开和渗血等。如果皮瓣颜色红润,切口没有开裂或渗血,说明皮瓣存活。如果皮瓣发黑、脱皮,且切口难以愈合,则说明皮瓣坏死。结果所有病例的随访时间为3个月至5年,平均为3年,均获随访,术后切口都在Ⅰ期愈合,没有出现切口开裂或感染等情况。皮瓣存活良好,颜色与耳廓前部的皮肤相似,无肿瘤复发。结论耳后带蒂皮瓣技术修复耳廓前部良性肿瘤的术后皮肤缺损的效果确定。是一种对外观影响小简单易行的修复方法。Objective To investigate the clinical efficacy of postauricular pedicle flap in repairing postoperative skin defects caused by benign preauricular tumors.Methods Twenty-one cases of postoperative skin defects caused by preauricular tumors were repaired with a postauricular tipped flap,all with unilateral ear onset.After resection of the preauricular tumor,the postauricular flap was selected at the same level of the preauricular skin defect using the postauricular sulcus as a marker.A 2/3 size flap was taken from the posterior mastoid surface of the ear and a 1/3 size flap from the dorsal surface of the auricle respectively.The postauricular flap was rotated 90°to 180°through the tunnel to the anterior soft tissue defect,and the flap was intermittently sutured to the anterolateral trabecular skin of the auricle.Postoperative observations are as follows,the flap color,whether the incision was dehiscent,and blood leakage.If the flap was red in color and the incision was not cracked or oozing blood,the flap was alive.If the flap was dark,peeling,and the incision was difficult to heal,the flap was necrotic.Results All cases were followed up for a period of 3 months to 5 years,with a mean of 3 years.All the postoperative incisions healed in the first stage and there was no incision dehiscence or infection.The flaps survived and grew well,the color of the flap was similar to that of the preauricular skin,and no tumor recurrence was found.Conclusion The application of postauricular pedicle flap technique for the treatment of postoperative skin defect of preauricular tumor was satisfactory.The flap has a rich blood supply and a hidden donor area,and does not affect the appearance,which makes it a simple and easy method for repairing preauricular skin defects.

关 键 词：带蒂皮瓣 耳廓缺损 修复 

分 类 号：R739.61[医药卫生—肿瘤]