耳后皮下蒂岛状皮瓣修复耳甲腔皮肤缺损

Repair of auricular concha skin defects by postauricular island flap with subcutaneous pedicle

目的 探讨耳后皮下蒂岛状皮瓣修复耳甲腔皮肤缺损的治疗效果.方法 对2009年1月至2012年6月收治的12例耳甲腔皮肤缺损行耳后皮下蒂岛状皮瓣修复患者行回顾性分析.恶性肿瘤经术中病理检查确定基底及周缘无肿瘤细胞残留,根据创面大小设计耳后皮下蒂岛状皮瓣,经供区与缺损之间的隧道,转移至耳甲腔缺损处覆盖创面,耳后供区直接拉拢缝合.结果 共修复12例耳甲腔皮肤缺损患者,创面以1.5cm×2.5cm^2.5cm×3.0cm大小不等皮瓣覆盖,术后皮瓣血运良好.随访14～55个月（平均28个月）,肿瘤无复发,局部瘢痕不明显,皮瓣色泽与正常皮肤相协调,外耳郭形态正常,患者对耳郭外观满意.结论 耳后皮下蒂岛状皮瓣是临床修复耳甲腔皮肤缺损的一个简单、方便、有效的方法之一.

Objective To study the effect of postauricular island flap with subcutaneous pedicle on repairing auricular concha skin defects. Methods From January 2009 and June 2012, 12 patients with auricular concha skin defects were treated by postanficular island flap with subcutaneous pedicle. Their clinical materials and follow up re- sults were retrospectively analyzed. Postauricular island flap with subcutaneous pedicle which was designed according to the size of the defect was pulled through the tunnel between the donor area and conchal cavity defect to cover the defect. All lesions were confirmed during surgery with frozen section technique, and no margins were involved with tumor cells. The donor defect was closed primarily. Results Repair of 12 auricular concha skin defects was accom- plished by postaurieular island flap with subcutaneous pediele. The flap size ranged from 1.5 cm× 2. 5 cm to 2.5 cm × 3.0 cm. The follow-up period was 14 to 55 months （ mean 28 months）. There＇s no recurrence of tumor; the flaps matched the skin color, thickness and texture; scars were well hidden. Patients are satisfied with the cosmetic outcome. Conclusion Postanricular island flap with subcutaneous pedicle is a relatively convenient and effect choice for anterior auricular concha skin defects.