多耳畸形的手术治疗与病因分析

Surgical treatment and etiological analysis of polyotia

目的探讨多耳畸形的手术治疗方法及其病理发生机制。方法多耳畸形的手术治疗方法较为灵活，主要针对耳屏区域的多余组织进行耳屏的塑形，对于此区域的凹陷畸形行组织充填。对于多耳畸形后部耳廓的形态和位置进行对侧耳廓复合组织移植和Z成形术整复。结果2003至2008年共治疗9例多耳畸形，其前部的多余组织被切除，耳屏被重建。其中有6例行凹陷畸形充填，4例行耳廓组织复合移植，2例行耳垂下方Z成形术。术后基本恢复正常的耳形态结构，位置和对侧耳廓对称。结论多耳畸形通过手术修复可获得外观自然、对称的耳廓，其发生与神经嵴细胞的异常迁移有关。

Objective To explore the surgical treatment and pathologic mechanism of polyotia. Methods The operative methods for polyotia were flexible. The main procedures were aimed at the remodeling of tragus with the redundant tissue. Tissue transplantation was used to correct the depression deformity. Compound auricular tissue transplantation and Z-plasty were used for correction of the malformation at the posterior part of polyotia. Results From 2003 to 2008, 9 patients with polyotia were treated. The tragus was reconstructed after resection of redundant tissue. The depression deformity was corrected with tissue infilhng in 6 cases. The compound auricular tissue transplantation was performed in 4 cases. Z-plasty at the lower ear lobe was performed in 2 cases. The appearance and the location of the reconstructed ears looked symmetric to the healthy ear. Conclusions Natural and symmetric appearance of reconstructed ear can he achieved in polyotia. The abnormal migration of neural crest cell might be the pathologic mechanism of polyotia.