残耳复合组织游离移植行耳屏再造

Tragus reconstruction with free composite tissue grafting of residual ear

目的:探讨利用残耳复合组织游离移植耳屏再造的方法,评价其优缺点及适应证。方法:选择小耳畸形患者三期再造耳修整时,残耳组织足够,存在耳甲腔而无耳屏,或已行外耳道再造而耳屏缺如的患者15例。根据残耳组织的形状,切取一定大小的梭形、中央略隆起的残耳复合组织,在拟再造的耳屏部位作纵向切口,将残耳复合组织插入切口内,缝合即可。结果:残耳复合组织再造的耳屏成活良好,无1例出现组织坏死的情况,再造的耳屏形状逼真,3～6个月随访无明显变形。结论:对于存在耳甲腔或外耳道再造后,仍无耳屏的患者,拟再造耳屏的周边组织量有限,不足以行耳屏的再造,而采用多余的残耳复合游离移植,则可以合理利用组织,组织的成活率高,再造的耳屏形状良好。

Objective To investigate a tragus reconstruction method by free composite tissue grafting of residual ear, in order to assess the value and indication of them. Methods Fifteen patients who had adequate residual ear tissue and cavity of auricular concha or reconstructed external auditory canal were selected to use this new method when the reconstructed auricular were repaired once more. The shuttle-shape and uplifted composite tissues in the middle of residual ear were cut ,and then insert into the vertical incision in the place which the tragus will be made. Results All the tragus reconstructed existence perfectly, none of them suffered from necrosis. And the appearance of all reconstructed tragus was pleasing. There were no deformation in all the reconstructed tragus after three to six months follows-up. Conclusion The tissues round the tragus was not enough to make the tragus in the patients who had cavity of auricular concha or external auditory canal reconstructed. So the free composite tissue of residual ear ,which will be deserted in the reconstructed auricular repair usually, could be used to make the tragus. And the grafted tissues existed perfectly and the appearance of tragus was pleasing too.