个性化肋软骨采集及耳支架雕刻

Individualized Fabrication and Application of Autogenous Cartilage Framework in Auricular Reconstruction

目的探讨个性化应用自体肋软骨制作三维耳廓支架的方法。方法个性化自体肋软骨支架制作流程包括术前评估、肋软骨采集、雕刻及拼装。根据参照耳廓外形特征,肋软骨的发育情况及钙化程度等个体因素,确定个性化耳支架制作方法。结果自2011年9月1日至2012年9月1日,我科治疗单侧小耳畸形患者并实施自体肋软骨支架植入耳再造二期手术435例,其中男345例,女90例,左耳138例,右耳297例,年龄5.5至48岁。我们在耳再造术后1个月开始随访,随访时间一般不少于1年,随访显示:再造耳支架稳定,无变形和吸收,再造耳外形良好,与参照耳廓形态接近。结论个性化自体肋软骨耳支架制作方法可行性强,设计灵活,节省肋软骨,制作方便,结构稳定,再造耳形态逼真、自然协调、立体感强。

Objective To study individualized fabrication and application of autogenous cartilage framework in auricular reconstruction. Methods The process of individualized fabrication of cartilage framework consisted of pre-surgical evaluation, cartilage harvesting, carving and assembling. Individual factors, such as auricular features, rib cartilage development and calci- fication were taken into consideration when designing individua cartilage framework. Results The follow-up period ranged from July 2011 to December 2012. Consistent and satisfactory results were achieved in all 782 patients with microtia in this se- ries （820 ears）. Conclusion Individualized fabrication and api31ication of autogenous cartilage framework shows the advantage of yielding natural appearance and proving accurate fabrication, and can be of great value in auricular reconstruction.