耳廓复合组织瓣游离移植修复鼻翼缺损

Auricular Composite Tissue Flap for Repairing Nasal Ala Defect

目的探讨用自体耳廓复合组织瓣游离移植修复鼻翼缺损的效果.方法自2003年1月至2013年5月以来,应用耳廓复合组织瓣游离移植的方法修复50例鼻翼缺损.缺损面积0.5 cm×0.7 cm^1.3 cm×1.5cm.根据鼻翼缺损面积的大小,在同侧耳廓上段切取全层楔形的复组织瓣,将复合组织瓣嵌入鼻翼缺损区,严密缝合后适度加压固定,供区避开耳软骨直接缝合,术后配合高压氧、丹参多酚酸盐治疗5~7 d.结果有48例取得良好效果,2例出现部分组织瓣坏死,再次行耳廓复合组织瓣游离移植术,取得良好效果.随访3月~5 a,耳廓组织瓣收缩率<10%,手术切口周围有线性疤痕形成,色泽匹配,鼻翼大小相近,鼻孔对称,供区无瘢痕增生,患者对总体外观均比较满意.结论应用自体耳廓复合组织瓣游离移植修复中小面积鼻翼缺损可以很好地恢复鼻翼形态结构,鼻翼畸形得到明显改善,鼻孔对称,方法简单易行。

Objective To discuss the effects of repairing nasal ala defects by free transplantation of autogenous auricle composite tissue flap. Methods 50 cases with nasal ala defects were repaired by free auricular composite tissue flap transplantation from Janu 2003 to May 2013. The defects size was 0.5cm x 0.7cm^1.3cm x 1.5cm. According to the size of the defects, full thick wedge-shaped auricle composite tissue flap were cut off, then inserted into the nasal ala defects area and fixed stablely, the donor sites were sutured directly avoiding ear cartilage. Salvianolate and hyperbaric oxygen were used in postoperative treatment for 5-7 days. Results 48 cases achieved good results, 2 cases had partial necrosis of composite tissue flap after operation, also achieved good results after reoperation. Over 3 months^5 years follow-up, all cases had satisfactory results. The volume of auricle composite tissue flap reduced less than 10%. Surgical incisions had a linear scar, good color matching, nostril symmetry. All patients were satisfied with the overall appearance. Conclusions Autogenous auricle composite tissue flap free transplantation for repairing middle and small size of nasal ala defects can recover ala formation and structure very well, nasal appearance can be improved greatly with nostril symmetry. There is no hypertrophic scar in donor sites. This method is simple and easy,and is also a good method for repairing nasal ala defects.