耳后真皮脂肪的组织学特点以及在唇鼻凹陷畸形治疗中的应用

The histological characteristics of postauricular dermis-fat and its application in the treatment of depressed deformities of the nose and lip

目的 观测耳后真皮脂肪的组织学特点，并探讨其在唇鼻畸形治疗中的应用。方法 从11具成人新鲜尸体上获得上唇、耳后以及腹部皮肤及皮下组织标本，并比较这些区域组织结构的差异，包括表皮、真皮厚度与结构、真皮内成纤维细胞或纤维细胞数量以及皮下脂肪结构。临床上应用耳后真皮脂肪游离移植于隐性唇裂（7例）与唇裂继发畸形（4例）的凹陷畸形矫正、鼻部凹陷畸形（4例）以及上唇瘢痕凹陷（2例）的填充。结果 耳后真皮脂肪与上唇真皮脂肪结构相近，而与腹部真皮脂肪有明显区别。应用耳后真皮脂肪瓣游离移植矫正唇鼻畸形共17例，术后即刻效果满意。16例经随访6—18个月，畸形矫正效果仍满意。结论 从组织学结构以及临床应用中来看，耳后真皮脂肪在治疗唇鼻畸形中是一个理想的供区。

Objective To explore the histological characteristics of postauricular dermis-fat and its application in the treatment of depressed deformities of the nose and lip. Methods A comparative study of the thickness of the epidermis and dermis, and the numbers of fibroblasts and fibrocytes in the dermis of postauricular area, upper lip and abdominal wall of 11 adult fresh cadavers （6 male and 5 female subjects） was performed. Free postauricular dermis-fat was transplanted to treat the depressed deformities in 7 patients with inapparent cleft lip and 4 patients with secondary cleft lip, to fill the depressed deformity in 4 patients with nose deformity and 2 patients with upper lip scar. Results The construction of dermis-fat in postauricular area was more similar to that in upper lip than that in abdominal wall. 17 patients were operated with this method. The immediate result was satisfactory. Satisfactory results were also shown in 16 patients with 6 - 18 month follow-up. Conclusion It is an ideal method to apply postauricular dermis-fat grafts in the treatment of depressed deformities of the nose and lip.