多孔聚乙烯生物支架联合颞浅筋膜瓣在耳再造中的应用  

The application of porous polyethylene biological scaffolds combined with temporoparietal fascial flaps in auricular reconstruction

作　　者：林垦 杜玉玲 黄锐 李霞[1] 张珩颖 华玉慧 苏栋 马静[1] LIN Ken;DU Yulin;HUANG Rui;LI Xia;ZHANG Hangying;HUA Yuhui;SU Dong;MA Jing(Department of Otolaryngology Head and Neck Surgery,Kunming Children's Hospital,Kunming,650228,China)

机构地区：[1]昆明市儿童医院(昆明医科大学附属儿童医院)耳鼻咽喉头颈外科,昆明650228

出　　处：《临床耳鼻咽喉头颈外科杂志》2025年第2期147-151,157,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：云南省教育厅科学研究基金项目(No:2023Y0825);云南省教育厅科学研究基金项目(No:2023J0297);昆明市卫生科技人才培养项目“百工程”(No:2023-培养类别-00)。

摘　　要：目的:分析经头皮微创切口利用高密度多孔聚乙烯(Su-por)联合颞浅筋膜瓣一次手术在耳廓再造术中的应用效果。方法:本研究对2022年6月—2024年1月在昆明市儿童医院接受高密度多孔聚乙烯支架Ⅰ期耳廓再造术的50例(共50耳)患儿进行了回顾性分析。患儿均采用经头皮微创切口进行高密度多孔聚乙烯联合颞浅筋膜瓣的Ⅰ期耳再造术,并对术后治疗效果及并发症进行统计分析。结果:所有患儿术后再造耳均成活,术后随访6个月,所有患儿头皮微创切口瘢痕增生不明显,未见明显脱发。48例患儿再造耳廓对称,形态逼真且立体感强,随着随访时间延长,耳廓立体结构清晰,患者满意度增加,余2例患儿中有1例皮瓣坏死,经植皮换药后皮瓣成活;1例患儿由于瘢痕体质导致再造耳处切口出现瘢痕增生,耳廓形态欠佳,但头皮切口处瘢痕增生不明显。结论:经头皮微创切口进行高密度多孔聚乙烯联合颞浅筋膜瓣的Ⅰ期耳再造术,耳廓对称,能更好地展现再造耳廓精细结构,头皮微创切口能有效降低术后瘢痕增生、头皮切口脱发的发生概率,随着时间延长,再造耳立体结构清晰,是一种有效的耳再造方法。Objective To analyze the application efficacy of employing high-density porous polyethylene(Su-por)in combination with temporoparietal fascial flaps via a minimally invasive scalp incision in auricular reconstruction.Methods This study carried out a retrospective analysis of 50 patients(50 ears in total)who underwentprimary auricular reconstruction with a Su-por scaffold in our hospital from June 2022 to January 2024.All patients underwent primary auricular reconstruction using a minimally invasive scalp incision with high-density porous polyethylene(Su-por)and temporoparietal fascial flaps.The postoperative treatment effects and complications were statistically analyzed.Results The reconstructed ears of all patients survived.After 6 months of follow-up,the scar hyperplasia of the scalp minimally invasive incision was not obvious in any patient,and no significant hair loss was observed.The reconstructed auricle of 48 patients had a realistic shape and strong three-dimensional sense.With the extension of follow-up time,the three-dimensional structure of the auricle became clearer,and patient satisfaction increased.Among the remaining two patients,one case of flap necrosis survived after skin grafting and dressing changes.One patient had scar hyperplasia at the incision of the reconstructed ear due to a scar-prone constitution,and the shape of the auricle was not ideal,but the scar hyperplasia at the scalp incision was not obvious.Conclusion One-stage ear reconstruction with high-density porous polyethylene(Su-por)combined with superficial temporal fascia flap through a minimally invasive scalp incision can better show the fine structure of the reconstructed ear.The minimally invasive scalp incision can effectively reduce the occurrence of scar hyperplasia and postoperative alopecia at the scalp incision.

关 键 词：耳廓再造术 先天性小耳畸形 生物支架 高密度多孔聚乙烯材料 

分 类 号：R764.7[医药卫生—耳鼻咽喉科]