外伤后耳郭缺损的修复

Repair of traumatic auricle defect

目的探讨外伤后耳郭缺损的修复方法。方法采用皮肤软组织扩张法,利用健耳相片,通过计算机photo-shop软件数字化翻转处理,形成即要再造耳郭的相片,然后进行耳郭软骨支架的雕刻,用扩张后的患耳乳突区皮瓣覆盖雕刻的自体肋软骨耳郭支架,行耳郭再造。结果随访1～9年,36例(36耳)外伤后耳郭缺损均获得满意修复,修复后的耳郭形状逼真,再造耳郭的大小、高度、颅耳角角度和健耳匹配,移植的软骨支架无变形、吸收,再造耳郭色泽、感觉正常。结论用皮肤软组织扩张法,结合数字化技术形成的患耳相片雕刻的自体肋软骨耳郭支架行耳郭再造,效果满意、并发症少,是外伤后耳郭缺损较好的治疗方法。

Objective To investigate the therapy for auricle defect after trauma. Methods With expanded local skin and cartilaginous skeleton based on the digital flipped photo of health ear, auricle defect was repaired by the flap from mastoid area covering autologous rib cartilage. Results All cases were followed-up from one year to nine years. The results of 36 cases （ 36 ears） were satisfying, with the similar ear size, location, and skull-ear angle as the healthy ear. Reconstructed ear showed normaJ in skin color and feeling,without deformation and absorption. Conclusion With ex- panded local skin and digital technology, Auricle reconstruction by auto/ogous rib cartilage is satisfying with few com- plications. It is a good therapy for auricle defect after trauma.