先天性小耳畸形的耳廓再造

Auricle reconstruction of microtia

目的探讨先天性小耳畸形的耳廓再造与重建方法。方法2003年1月至2012年12月，采用皮肤软组织扩张法，利用健耳相片，通过计算机photoshop软件数字化翻转处理形成即要再造耳廓的相片，然后进行耳廓软骨支架的雕刻，用扩张后的患耳乳突区皮瓣覆盖雕刻的自体肋软骨耳廓支架行耳廓再造。结果1102例（1165耳）经过6个月一10年的随访观察。其中56例（56耳）再造耳廓有不同程度的软骨吸收、变形；2例（2耳）肋软骨支架感染、肋软骨液化、坏死；1044例（1107耳）再造耳廓与健耳匹配，凹凸结构显示清晰，形状相似、逼真，颅耳角的角度与健耳对称。结论用皮肤软组织扩张法行耳廓再造，术中应用数字化技术形成患耳相片指导自体肋软骨耳廓软骨支架的雕刻，效果满意、并发症少，是先天性小耳畸形较好的治疗方法。

Objective To investigate the methods of auricle reconstruction for microtia. Methods Cases treated between January 2003 and December 2012 were reviewed. Local skin was expanded and the autologous rib cartilaginous skele- ton was shaped based on the digital images of auricle frames generated with the Photoshop software using photos of the con- tralateral normal auricle. The skeleton was then wrapped in expanded local skin flap to complete reconstruction. Results Pa- tients （1,165 ears） were followed-up for six months to ten years. Cartilage frame absorption and distortion of various degrees were seen in 56 patients （56 ears）and infection in 2 patients with liquefaction and necrosis of the cartilage framework. The reconstructed ear showed good match to the contralateral ear in 1,044 cases （1,107ears）, with clear structural features, com- parable contours and symmetrical skull-ear angle. Conclusions In addition to adequate local skin expansion, the use of dig- ital design technology in guiding preparation of autologous rib cartilage skeleton improves auricle reconstruction outcomes with few complication, It helps improve therapy for microtia.