四种方法耳屏再造术

The experience of four tragus reconstruction methods

目的探讨耳屏再造的四种手术方法,评价其优缺点及适应症。方法分别采用"M"形皮瓣法、带耳甲腔残迹的长方形皮瓣、耦合舌形皮瓣及副耳转移法等行耳屏再造术治疗耳屏缺损患者共64例。结果各种方法再造的耳屏外观均较为满意,且各有其适应症:"M"形皮瓣法适用于无耳屏且无耳甲腔患者;带耳甲腔残迹的长方形皮瓣法适用于无耳屏,但有凹陷性耳甲腔残迹者;耦合舌形皮瓣法适用于无耳甲腔或行外耳道再造术后耳甲腔上下边缘均存在多余组织者;副耳转移法适用于耳屏处存在副耳的患者。结论对于各种无耳屏的患者应根据局部的情况,因地制宜地采用不同的方法行耳屏再造,以求合理利用组织,再造出外观满意的耳屏。

Objective To investigate the indication and efficacy of four methods for tragus reconstruction. Methods The M-shaped flaps, rectangular flaps with the undeveloped conchal cavity, coupling tongue-shaped flaps, and preauricular tags were used to reconstruct the tragus in sixty-four patients who lacked of tragus. Results The appearance of all of the reconstructed tragus was satisfactory. The M-shaped flaps was applied for reconstruction of the tragus in patients who lack both the tragus and cavity of auricular concha, the rectangular flaps with the undeveloped conchal cavity for patients who lack the tragus but having the undeveloped conchal cavity, the coupling tongue shaped flaps for patients who lack the conchal cavity or have redundant tissues both in the upper and underneath edge of the conchal cavity after external auditory canal reconstruction, and the preauricular tags for patients who lack the tragus and have preauricular tags before the conchal cavity. Conclusion These methods should be used depending on the local condition of deformed ears in order to get a satisfactory appearance.