局部软骨瓣翻转法矫正隐耳畸形  

Correcting cryptotia by overturning constricted cartilage

作　　者：李意源 张群[1] 许志成[1] 许枫[1] 李大涛[1] 陈霞[1] 张如鸿[1] LI Yiyuan;ZHANG Qun;XU Zhicheng;XU Feng;LI Datao;CHEN Xia;ZHANG Ruhong(Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科》2023年第6期530-534,共5页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：上海市科学技术委员会临床医学研究中心项目(22MC1940300)。

摘　　要：目的探讨隐耳矫正的新方法,通过游离并翻转收缩的软骨,彻底改变其力学方向以达到稳定的手术效果。方法2010~2022年,对30例先天性隐耳畸形患者采用翻转软骨瓣的方法进行隐耳矫正术。术中掀起耳后皮瓣后,完全暴露外耳廓上极软骨的背侧,彻底松解离断附着于此的耳上肌。分离切取并前后翻转对耳轮区域尖锐、挛缩的矩形软骨瓣。于耳后乳突头皮区域皮下广泛潜行分离,皮瓣向颅耳沟方向推进并固定于乳突区骨膜上,以保证切口无张力缝合。结果所有患者中,22例为单侧发病,8例为双侧发病,术后随访6~48个月,均维持良好的手术效果,未出现局部皮瓣坏死或其他并发症,没有患者需再次接受手术修复。结论这种翻转软骨瓣的新方法对中重度隐耳患者普遍适用,其创新点在于彻底改变原本畸形挛缩的对耳轮区域软骨的力学方向。Objective To explore a new method of correcting cryptotia by overturning constricted cartilage.By this method,the mechanical direction of cartilage is changed.Methods Thirty cryptotia patients were treated from 2010 to 2022.The retroauricular skin flap was elevated to expose the posterior aspect of the upper auricular cartilage.The abnormal insertion of the auricular intrinsic muscles was detached.Cut and overturned the sharp antihelical cartilage,and the scalp skin flap was undermined and advanced toward the postauricular sulcus.The edge of the retroauricular scalp flap was fixed on the mastoid periosteum to release tension of the incision.Results The 22 unilateral and 8 bilateral cryptotia patients were followed up for 6-48 months.Favorable results maintained without skin necrosis or other complications.No case needed revision surgery.Conclusion This new method of overturning the cartilage flap is generally applicable to moderate and severe patients with cryptotia,and its innovative point is to completely change the mechanical direction of constricted cartilage in the region of the antihelix.

关 键 词：先天性隐耳畸形 隐耳矫正术 游离软骨瓣 耳廓畸形 

分 类 号：R622[医药卫生—整形外科]