胶合软骨支架行外耳再造术

Auricle reconstruction with cohered costal cartilage

目的 报道外耳再造软骨支架成形固定的一种新方法。方法 临床应用 11例 ,Ⅰ期行传统耳后组织扩张器置入 ,预制耳后薄皮瓣 ,解剖层次为颞浅筋膜浅层。Ⅱ期取自体胁软骨为支架材料 ,根据健侧模样雕切成耳轮、对耳轮支架条 ,用医用胶粘合、拼接、点补、固定。通过拼接矫正耳轮上角及延长耳轮脚 ,点补形成耳轮结节、对耳屏及修整欠缺处 ,然后 ,耳轮与对耳轮支架进行粘合 ,形成胶合软骨支架。结果 除第 1例取第 8,9两肋软骨外 ,其余10例均取单根肋软骨。胶合的软骨支架系统稳固 ,外观逼真 ,立体感强 ,愈后无排异 ,轮廓清晰 ,随访 1～ 3年 ,支架稳定 ,无塌陷。结论 医用胶行软骨支架固定方便、牢固、节省材料 ,无毒副作用 ,塑形逼真 。

Objective To report a new method of auricle reconstruction with cohered costal cartilage framework. Methods Traditional tissue expanders were placed in the temporal superficial fascia of 11 patients to obtain post-auricular flaps. When the flap was enough, the autologous costal cartilage was dissected out, and sculptured into helix and antihelix framework according to the contralateral normal ear. They were cohered, repaired, and fixed by medical glue. After adjusting the upper angle of helix, protracting crus of helix, and repairing auricular tubercle, antitragus and defects, the frameworks of helix and antihelix were cohered to form the cartilage framework. Results Ten patients were removed one costal cartilage, except only one patient who was removed the 8th and 9th costal cartilages. These frameworks were stable, vivid and had good three-dimensional shape. There was no rejection 1 to 3 years after the operation and had no apparent collapse. Conclusion Costal cartilage framework cohered by medical glue is stable, convenient, economic, feasible and of no toxic side effects.