自体肋软骨移植修复重度隐耳畸形  

Correction of Severe Cryptotia with Autologous Costal Cartilage Transplantation

作　　者：刘玉红 刘新刚 薄琳 马启发 苏法仁 LIU Yuhong;LIU Xingang;BO Lin;MA Qifa;SU Faren(Department of Otolaryngology-Head and Neck Surgery,Chinese Armed People’s Police Force Shandong Provincial Corps Hospital,Designated Unit for Military Ear Deformity Correction,Jinan,250014,China)

机构地区：[1]武警山东省总队医院耳鼻咽喉头颈外科全军耳畸形矫治定点单位,济南250014

出　　处：《中华耳科学杂志》2024年第5期715-717,共3页Chinese Journal of Otology

基　　金：军队保健和计生专项科研课题项目(22JSZ08)。

摘　　要：目的探讨应用自体肋软骨移植法修复重度隐耳畸形的治疗效果。方法选取2020年1月至2023年1月武警山东省总队医院耳鼻咽喉头颈外科收治的重度隐耳畸形患者17例(20耳),其中男性12例,女性5例;年龄6~28岁,平均年龄(9.4±5.2)岁;单侧隐耳畸形14例,双侧3例。应用自体肋软骨移植法手术治疗。将隐匿部位耳廓从底部掀起,应用雕刻的半月形自体肋软骨块垫高隐耳耳廓,使两侧耳廓高度及颅耳角角度达到一致。若患者伴有外耳轮畸形,外耳轮无软骨支撑,需要做外耳轮成形术。肋软骨移植后,根据皮肤缺损的程度,直接拉拢缝合切口或者应用中厚游离皮片植皮覆盖创面。结果术后隐匿埋藏的耳廓上极显露良好,颅耳角角度正常,外耳轮舒展自然。有1例患者术后10 d出现外耳轮软骨末端局部凸起,经修整后愈合良好。术后随访3个月~1年,未出现耳廓上极回缩及外耳轮移位变形等问题,患者对手术效果均满意。结论自体肋软骨移植法修复重度隐耳畸形手术效果良好,术后并发症少,值得临床应用。Objective To report outcomes of autologous costal cartilage transplantation in the correction of severe cryptotia.Methods Patients with severe cryptotia(n=17,aged 6-28 years,mean=9.4±5.2 years,12 males and 5 females,14 unilateral and 3 bilateral,total 20 ears)were treated with autologous rib cartilage transplantation at the Department of Otolaryngology-Head and Neck Surgery,Chinese Armed People’s Police Force Shandong Provincial Corps Hospital,from January 2020 to January 2023.The hidden part of the auricle was raised from the base to the same height and angle as the contralateral ear and supported using the autogenous costal cartilage block.If present,helix deformity not supported by the cartilage was also corrected.Depending on the extent of skin defect,a medium-thick free skin graft was used to close the wound when needed.Results Postoperatively,the superior auricular margin was well formed,with normal cranioauricular angles and naturally expanded helix.Local bulging at the foot of the helix cartilage occurred in 1 patient 10 days after surgery,which resolved well after repair.Follow-up from 3 months to 1 year showed no retraction of the superior margin or displacement of the helix.Patients were satisfied with the outcomes.Conclusion Autologous costal cartilage transplantation for correction of severe cryptotia can provide good results with few postoperative complications,and is worthy of clinical adoption.

关 键 词：隐耳畸形 自体肋软骨 手术治疗 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]