耳后筋膜瓣的改良设计及其在颅耳沟重建术中的效果  

Modification of the retroauricular fascia flap and its application in staged auricular reconstruction

作　　者：李意源 张如鸿[1] LI Yiyuan;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》2024年第2期205-207,共3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：目的评价耳后筋膜的组织形态学特征,并对其进行几何学设计改良,以改善颅耳沟重建术后颅耳沟外观,并减少术后局部并发症的发生。方法对16例患者进行耳后筋膜厚度的超声测量,通过几何学设计得到耳后上筋膜瓣,并将该方法用于125例颅耳沟重建术。结果耳后筋膜由上至下厚度逐渐增加。耳后上筋膜瓣较传统的耳后筋膜瓣在手术操作上更简单,术后的颅耳沟形态更自然,耳后局部皮肤坏死和瘢痕增生减少。结论最大限度利用接近顶侧耳后筋膜组织设计的改良耳后上筋膜瓣,在手术效果及减少术后并发症方面均优于传统耳后筋膜瓣。Objective To evaluate histomorphometric features of the retroauricular fascia and geometrically re-design a novel fascia flap to improve the posterior appearance of reconstructed ear and reduce complications after ear elevation.Methods The thickness of retroauricular fascia was measured by ultrasound in 16 patients.The posterosuperior auricular fascia flap was designed by geometry.And the method was applied in 125 cases of ear elevation.Results The fascia layer thickness increased from superior to inferior.By using posterosuperior auricular fascia flap,the surgical procedure became easier,the posterior appearance of reconstructed ear was more natural after operation,and the incidence of postauricular hypertrophic scarring and partial skin graft necrosis also decreased.Conclusion The modified posterosuperior auricular fascia flap designed to maximize the use of the posterior fascia tissue of the parietal side is superior to the traditional retroauricular fascia flap in terms of surgical effect and reduction of postoperative complications.

关 键 词：先天性小耳畸形 颅耳沟重建 耳后筋膜 耳后上筋膜瓣 

分 类 号：R622[医药卫生—整形外科]