耳甲腔型小耳畸形残耳组织的合理应用

Usage of Residual Ear in Auricular Reconstruction for Concha-Type Microtia

目的探讨耳甲腔型小耳畸形的残耳组织在耳再造术中的合理应用方法。方法2011年8月-2013年6月，我科对85例耳甲腔型小耳患者（88只耳）行扩张器法耳再造术。一期行耳后扩张器植入和残耳耳垂旷置。二期取自体肋软骨做扩张皮瓣耳廓再造术，并利用旷置的耳垂行转位术与再造耳支架衔接。三期将剩余的残耳组织做再造耳的局部修整。结果随访6～15个月，再造耳立体感强，以残耳形成的耳垂外形丰满，覆盖于耳甲腔处的残耳耳甲皮瓣色泽自然，垫于耳支架后方的残耳软骨弹性好，患者及家属均满意。结论耳甲腔型小耳畸形的残耳组织量丰富，在耳再造各期手术中的综合利用方法值得推广。

Objective To study the utility of existing residual ear structures in auricular reconstruction for concha-type microtia. Methods From August 2011 to July 2013, 85 patients with mierotia （88 ears） were treated with staged auricle recon- struction treatment using tissue expander. The first stage involved placement of a tissue expander. Reconstruction using the ex- panded skin flap and autogenous cartilage framework was performed in the second stage, completed with linking the existing earlobe to the reconstructed-ear scaffold. In the third stage, unused residual ear structures were exploited to improve final mor- phology of the reconstructed-ear. Results The patients were followed up for 3 months to 2 years with satisfactory aesthetic re- sults. Earlobes appeared natural, the residual flap coveting the coneha survived well, and the residual auricular cartilage mat- ted behind the scaffold exhibited good elasticity. Conclusion Residual auricular tissues in eoneha-type microtia is easily available and can be very useful in staged auricle reconstruction.