耳后皮瓣翻转修复巨大黑素细胞痣切除后耳垂缺损一例  

Retroauricular Flap Reversal to Repair Earlobe Defect after Removal of Giant Congenital Melanocytic Nevus:A Case Report

作　　者：刘瑜[1] 赵焓杏 李正勇[1] 陈志兴[1] LIU Yu;ZHAO Hanxing;LI Zhengyong;CHEN Zhixing(Department of Burn and Plastic Surgery,West China Hospital of Sichuan University,Chengdu 610000,Sichuan,China)

机构地区：[1]四川大学华西医院整形外科/烧伤科,四川成都610000

出　　处：《中国美容医学》2025年第3期82-84,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究耳后皮瓣翻转修复巨大黑素细胞痣切除后耳垂缺损的疗效。方法:选取2020年2月笔者医院耳垂前部巨大黑素细胞痣(Giant congenital melanocytic nevus,GCMN)患者1例,进行局部病灶切除并使用耳后皮瓣经耳甲腔软骨翻转至耳垂前部进行修复,术后随访2年,观察患者术后形态并进行记录。结果:局部未见黑素细胞痣复发,耳后皮瓣修复耳垂形态良好,未见明显瘢痕增生,皮瓣与周围组织外观差异小,术后效果良好,随访2年外观形态良好,患者满意度高。结论:GCMN常存在恶变风险,存在于耳垂部位常常影响患者美观,切除后难以使用简单的皮瓣转移进行覆盖,皮肤移植覆盖则对患者外观有较大影响,修复效果欠佳。该例使用耳后皮瓣经耳甲腔软骨翻转修复耳垂前部痣切除后大面积皮肤软组织缺损的病例,结局良好,为耳垂部位巨大非平面的创面修复提供了新的解决策略。Objective To investigate the effect of retroauricular flap reversal in repairing the ear lobe defect after removal of large melanocyte nevus.Methods A patient with Giant congenital melanocytic nevus (GCMN) in the front of the earlobe of the author's hospital in February 2020 was selected for local resection and retroauricular flap was turned over to the earlobe through the ear cavity cartilage for reparation.Followed-up for 2 years after surgery.The postoperative morphology of the patients was observed and recorded.Results No recurrence of melanocyte nevus was observed locally,the shape of earlobe repaired by retroauricular flap was good,no obvious scar hyperplasia was observed,the appearance difference between the flap and surrounding tissue was small,the postoperative effect was good,the appearance was good after 2 years of follow-up with highly satisfaction of patient.Conclusion GCMN often has the risk of malignant transformation,and the presence of GCMN in the earlobe often affects the appearance of patients.It is difficult to use simple flap transfer to cover the ear lobe after resection,and skin graft coverage has a greater impact on the appearance of patients,and the repair effect was poor.In this case,retroauricular flap was used to repair large area of skin and soft tissue defects after removal of nevus in front of earlobe by turning over through ear conch cavity cartilage.The outcome was good,which provided a new solution strategy for large non-planar wound repair of earlobe.

关 键 词：巨大黑素细胞痣 耳后皮瓣 耳垂缺损 耳甲腔 皮瓣转移 

分 类 号：R758.51[医药卫生—皮肤病学与性病学]