耳垂缺损的不同方法修复效果观察

Observation on the result of earlobe reconstruction by different methods

目的探讨用不同方法行耳垂缺损再造修复的可行性及优缺点。方法1995年1月-2006年7月共收治耳垂缺损患者45例,根据耳垂缺损的大小及对侧耳垂情况分别采用不同的手术方式进行修复再造。对于18例缺损面积较小的耳垂缺损采用耳轮滑行推进皮瓣法修复,15例中等程度缺损患者采用耳后皮瓣法修复,12例完全缺损,或虽不是完全缺损但健侧耳垂较大的患者采用皮肤扩张术+自体肋软骨移植法修复。结果45例患者分别采用上述方法进行再造修复后,耳廓、耳垂形态良好,随访4个月-8年,效果满意。结论对于不同程度的耳垂缺损畸形,应根据具体情况采用相应的修复方法,以达到最佳治疗效果。对于耳垂完全缺损或虽不是完全缺损但对侧耳垂较大的患者,应首选皮肤扩张术+自体肋软骨移植法,以获得形态良好而持久的再造耳垂。

Objective To investigate the feasibility, advantage and disadvantage of various techniques used for earlobe reconstruction. Methods From January 1995 to July 2006, 45 patients of earlobe defect with various size were treated with different methods. The patients were divided into three groups： 18 patients with minor earlobe defects were treated with method of advancement skin flap, 15 patients with moderate earlobe defects were treated with method of post-auricular local skin flap, and 12 patients with major earlobe defects or total loss were treated with method of skin expansion combined with costal cartilage transplantation. Results In the 45 patients treated with aforesaid methods, postoperative appearances were satisfactory, and no flap necrosis occurred. After a routinely follow-up of 4 months to 8 years, no keloid or hypertrophic scars developed, all earlobes maintained a good shape without contraction or distortion, and they acquired comparable color and texture. All patients were satisfactory with the cosmetic appearance. Conclusion Different methods should be undertaken according to the different defect of the earlobe. Combination of skin expansion with costal cartilage transplantation is especially suitable for those patients with total earlobe defect or with a large earlobe on the opposite side, and it can provide a reconstructed earlobe with fine and persistent shape.