先天性小耳畸形Ⅰ期耳再造48例临床分析

Clinical analysis on one-stage total auricular reconstruction of 48 cases congenital microtia

目的探讨利用健侧耳后全厚皮片移植进行先天性小耳畸形Ⅰ期耳郭再造的方法。方法选择48例先天性单侧小耳畸形患者,应用自体肋软骨或Medpor材料做耳支架,利用患侧颞浅筋膜瓣反转包裹耳支架,并将蒂在前的残耳皮瓣覆盖于包裹耳支架的颞浅筋膜瓣表面,再将蒂在前面的残耳上方的三角形皮瓣覆盖在耳轮缘上方的颞浅筋膜瓣表面,其余颞浅筋膜表面移植健侧耳后全厚皮片。结果利用该方法进行Ⅰ期耳郭再造48例,手术均成功。随访1个月至1.5年,再造耳外形满意。结论用该方法进行Ⅰ期耳郭再造,具有疗程短、并发症较少、临床效果佳等优点。该方法切实可行,可于临床推广应用。

Objective To explore a method of one - stage ear reconstruction of congenital mierotia by using the retroauricular full - thickness skin graft from tminjured side. Methods Forty- eight cases with unilateral congenital mierotia were reconstructed by using autologous rib cartilage or Medpor material as auricular framework;fascia temporalis superficialis flap from injured side was reversed to wrap auricular framework; the surface of fascia temporalis superficialis flap which wraped the auricular frarneword was covered with the auricular skin flap with anterior pedicle from injured side, and the surface of fascia ternporalis superficialis flap above the helix rim was covered with triangle skin flap with anterior pedicle above injured side;the rest of the surface of fascia ternporalis superficialis was transplanted with the retroauricular full - thickness skin flap. Results Forty - eight cases with unilateral congenital mierotia were reconstructed by using the method mention-above. After 1-18 months following up, all were satisfied with reconstructed ear appearance and texture. Conclusion This one - stage auricle reconstruction is feasible with short time of threapy, few complications and good clinical effect. It is worth spreading clinically.