耳后延迟皮瓣自体肋软骨支架法外耳再造术

Auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap

目的 探讨耳后延迟皮瓣自体肋软骨支架法外耳再造术的临床效果.方法 手术分3期进行：Ⅰ期为耳后皮瓣延迟术,术后3周左右进行Ⅱ期手术;Ⅱ期为自体肋软骨支架再造、延迟皮瓣覆盖及自体中厚皮片移植外耳再造术,术后半年据情进行Ⅲ期手术;Ⅲ期行耳屏再造、耳甲腔加深和再造耳局部修整术等.结果 对先天性小耳畸形28例,31只耳,分次完成Ⅰ～Ⅲ期手术23只耳,余8只耳只完成Ⅰ、Ⅱ期手术.术后外耳位置、大小及形态良好,并发症少,患者及家属基本满意.结论 应用皮瓣延迟术不但可获取足够面积富有血运保障的菲薄皮瓣,而且方法简单、安全,所需时间短.耳后延迟皮瓣自体肋软骨支架法外耳再造术,是一种良好的外耳再造术方法.

Objective To summarize and explore the clinical effect of auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap.Methods The procedure involved three stages.The first stage was the delay procedure of postauricular skin flap.The second stage was the auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap about 3 weeks after the delay procedure.The third stage involved construction of tragus and conchal cavity and other local correction 6 months or longer after the second stage surgery.The clinical effect,patients＇ satisfaction and complication were observed.Results This method was used in 28 patients,31 ears of congenital microtia.23 cases completed auricular reconstruction with three stages,the other 8 cases completed only two stages.All auricular reconstruction were successful.The location,size and shape of reconstructive ears were good.The complications were few.The patients or their relatives were basically satisfactory.Conclusions Auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap is a safe and effective method.