耳后延迟皮瓣法外耳再造术中异位耳垂的处理  

Treatment of Ectopic Earlobe in Microtia Reconstruction Using Delayed Postauricular Skin Flap

作　　者：王玉婷 丁卫[1] 张博[1] 李高峰[1] 龙希任 WANG Yuting;DING Wei;ZHANG Bo;LI Gaofeng;LONG Xiren(Department of Plastic and Cosmetic Surgery,Hunan Provincial People's Hospital,Changsha 410005,Hunan,China)

机构地区：[1]湖南省人民医院整形激光美容外科,湖南长沙410005

出　　处：《中国美容医学》2023年第8期11-13,共3页Chinese Journal of Aesthetic Medicine

基　　金：湖南省卫生健康委科研计划(名称:耳畸形中异位耳垂处理临床手术方法的探讨,编号:202104100963)。

摘　　要：目的:耳后延迟皮瓣法外耳再造术中创新应用“Z”成形术和“Y-V”推进术处理残耳组织形成耳垂的效果探讨。方法:选取2019年1月-2022年9月的20例小耳畸形患者,在耳后延迟皮瓣法外耳再造术中,根据对侧耳垂位置设计患侧耳垂位置,将异位耳垂运用不规则“Z”成形或者不规则“Y-V”推进进行异位耳垂位置调整,最大限度地利用残耳组织形成柔软饱满又真实的耳垂。结果:20例患者异位耳垂移位后,耳垂血运良好,再造耳耳垂存活良好,无破溃;所有患者随访2个月~2年,再造耳与健侧耳位置基本对称,利用残耳形成的耳垂形态自然。结论:运用不规则“Z”成形术或者不规则“Y-V”推进耳后延迟皮瓣法外耳再造术中异位耳垂的处理是一种安全有效的处理方法。Objective This article explores the effect of innovative application of Z-plasty and"Y-V"advancement technique in treating residual ear tissue to form earlobe in external ear reconstruction with delayed postauricular skin fl ap.Methods A total of 20 patients with microtia from January 2019 to September 2022 were selected.The position of the affected ear lobe was designed according to the position of the contralateral ear lobe,and the position of the ectopic earlobe was adjusted by irregular Z-plasty or irregular"Y-V"advancement.Maximize the use of residual ear tissue to form a soft,plump and realistic earlobe.Results After ectopic earlobe displacement in 20 patients,the blood supply of the earlobe was good,and the reconstructed earlobe survived well without ulceration.All patients were followed up for 2 months to 2 years.The position of the reconstructed ear and the healthy side ear was basically symmetrical,and the earlobe formed by the residual ear was natural.Conclusion It is safe and effective to use irregular Z-plasty or irregular"Y-V"advanced delayed postauricular fl ap for the treatment of ectopic earlobe in external ear reconstruction.

关 键 词：外耳再造 异位耳垂 耳后延迟皮瓣法 小耳畸形 不规则“Z”成形术 不规则“Y-V”推进术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]