耳后联合双层筋膜瓣Medpor支架全耳再造的临床研究

Clinical study on joint expansion of double fascia flap wrapping Medpor for fullear reconstruction

目的：探讨采用颞顶筋膜瓣与耳后筋膜皮瓣（简称：耳后联合双层筋膜瓣）,Medpor支架行先天性小耳畸形全耳再造术的方法和效果.方法：采用颞顶支为血管蒂的岛状筋膜瓣移转至残耳乳突区耳后,与耳后乳突区筋膜皮瓣同期同步进行扩张,然后将扩张的耳后联合双层筋膜皮瓣包裹Medpor支架行全耳廓再造.结果：本组患者中经3个月～3年的随访,再造耳皮肤颜色与耳周缘面部相接近,微细结构清晰,颅耳角与健耳对称,形态结构好.结论：耳后联合双层筋膜瓣＋Medpor支架行全耳廓再造,既能有效避免支架外露和传统手术供区胸壁畸形,又能避免切取自体肋软骨增加的创伤及痛苦.再造耳皮肤颜色与正常肤色相似,形态满意,是一种值得推广的手术方法.

Objective This study on temporoparietal fascia flap and fascial flap in ear （Joint expansion of double fascia flap） wrap the Medpor to do congenital microtia full ear reconstruction.Methods Using temporal-parietal branch for the vascular pedicle,moved and expanded to mastoid area behind the ear fascia flap.Then the joint expansion of double fascia flap were wraped Medpor to do full-ear reconstruction.Results Followed up 3 months to 3 years,reconstructed ears had lifelike appearance and similar color with the surrounding skin.Auriculocephalic angle was good and symmetric with healthy ears.Conclusion Joint expansion of double fascia flap wrapping Medpor can avoid the exposed support and chest wall deformity.This method reveals lifelike ear structure.It is a relatively new surgical technique on full ear reconstruction.