自体肋软骨移植全耳再造15例临床分析

Clinical analysis on 15 cases of auricular reconstruction using autogenous costal cartilage framework

目的：探讨自体肋软骨移植全耳再造的手术方式及临床经验。方法：选择2003年7月～2008年3月住院的耳廓缺损15例患者，其中先天性小耳畸形12例，外伤后耳廓缺损3例。行全耳再造术，移植自体肋软骨雕刻成耳软骨支架，利用扩张的耳后皮肤软组织制备皮瓣覆盖耳软骨支架，形成再造耳。结果：15例随访6个月～4年，13例完成耳再造术，再造耳位置正常，皮肤质地良好，三维结构清晰，医患双方满意；扩张器埋置术后发生血肿1例，行扩张器取出；扩张器外露3例，经换药等处理后完成扩张过程；软骨支架外露2例，经换药处理后痊愈。结论：自体肋软骨移植结合耳后皮肤软组织扩张术行耳再造是目前首选的耳再造术式。

Objective： To explore the technique of auricular reconstruction using autogenous costal cartilage framework and study the clinical experience. Methods： Retrospective study include 15 cases of auricle deformities during July 2003 to March 2008 was carried out. Among them, 12 cases were microtia, and other 3 cases were aquired defects from injury. All cases underwent auricular reconstruction using retroauricular tissue expansion and autogenous costal cartilage framework. Results： All patients were followed up for six months to four years. 13 cases were performed by the two-stages operation and showed good aesthetic result. Both patients and surgeons were satisfactory. Hematoma occurred in one case. Expander exposure occurred in three cases. Cartilage framework exposure occurred in two cases. Conclusion： Surgical technique using retroauricular tissue expansion and autogenoUs costal cartilage framework is the first choice for auricular reconstruction.