成年小耳畸形患者全耳廓再造术的总结与分析  

Summary and analysis of total auricle reconstruction in adult microtia patients

作　　者：王秀 张朕坡 郭旭伦 杨卓凡 马腾霄[2] 张正文 Wang Xiu;Zhang Zhenpo;Guo Xulun;Yang Zhuofan;Ma Tengxiao;Zhang Zhengwen(Department of Plastic Reconstructive Surgery,Henan Plastic Surgery Hospital,Zhengzhou 450003,China;Department of Plastic Surgery,Henan Provincial People's Plastic Surger Hospital,Zhengzhou 450000,China)

机构地区：[1]河南整形美容医院整形修复外科,郑州450003 [2]河南省人民医院整形外科,郑州450000

出　　处：《中华耳鼻咽喉头颈外科杂志》2023年第5期476-480,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的观察成年小耳畸形患者全耳廓再造术的临床效果并总结经验。方法收集2016年6月至2021年6月应用改良Nagata二期法行全耳廓再造的成年小耳畸形患者的临床资料,共41例(42耳),其中男30例,女11例,手术时年龄31~63岁,中位数年龄37岁。所有患者均以自体肋软骨作为耳支架制作材料,采用改良Nagata二期法耳廓再造技术完成一期手术,术中根据肋软骨骨化状态采用不同的方法完成耳廓支架雕刻;一期术后6个月以后行二期耳颅角成形、耳后筋膜瓣转移、中厚植皮术完成立耳。结果所有患者均顺利完成二期手术,随访3~24个月,41例患者术后对再造耳廓形态均满意。结论根据成年患者自身肋软骨状态,采用不同肋软骨雕刻技术进行全耳廓再造可获得理想的手术效果。Objective To observe the clinical effect of auricle reconstruction in adult patients with microtia and summarize the experience.Methods Clinical data of adult patients with microtia who underwent total auricle reconstruction using the modified Nagata's two stage for microtia reconstruction from June 2016 to June 2021 were analyzed.A total of 41 adult patients(42 ears)with microtia were enrolled,including 30 males and 11 females,with the median age at the time of surgery of 37 years.Autogenous costal cartilage was used as the auricular framework for all patients in this group.The first stage surgery was performed according to the modified Nagata's two stage for microtia reconstruction procedure,cartilage auricular framework carving was performed by different methods according to the ossification state of adult costal cartilage.Six months following the primary operation,ear elevation and cranioauricular angle formation,retroauricular facial flap transfer and medium-thick skin grafting were performed in the second stage.Results All patients successfully completed two stage operation.During the follow-up of 3 months and 24 months,all the 41 patients were satisfied with the morphology of reconstructed auricle.Conclusion According to the costal cartilage status of adult patients,different costal cartilage carving techniques can be used for total auricle reconstruction to obtain ideal surgical results.

关 键 词：耳廓 小耳畸形 外科 整形 耳廓再造术 成年人 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]