Z成形术矫正隐耳及耳廓软骨畸形

Correction of cryptotia and cartilage malformation with Z-plasty without skin grafting

目的探讨治疗隐耳畸形的同时矫正对耳轮畸形，恢复耳廓的外形。方法在患者对耳轮后沟表面切开，切口要与耳后颅侧壁无毛区的V形切口形成z字，松解对耳轮后沟及耳支架底面的组织粘连，上提耳廓软骨支架，恢复耳支架形态及位置，再将耳后皮瓣转移至对耳轮后沟，以修复创面。供瓣区切口两侧皮下松解后缝合，以矫正隐耳畸形。结果临床治疗26例，随访6～12个月，所有患者隐耳畸形均得到矫正，对耳轮畸形大多恢复正常，双侧耳廓基本对称，外观满意。结论该方法在矫正隐耳畸形的同时，可矫正合并的对耳轮畸形，且无需植皮，操作相对简单，效果满意。

Objective To explore the curative effect of Z-plasty without skin grafting for correction of cryptotia. Methods Twenty-five cases （29 ears） with cryototia were corrected by Z-plasty without skin grafting in our department from June 2009 to January 2014. A Z-shaped incision with one arm on the back of antihelix and the other arm on the edge of hair was made on the back of ear and scalp. The adhesion on the back of antihelix cartilage was dissected and the cartilage framework was lifted and re-positioned. The postauricular flap was transferred to cover the wound on the back of antihelix. The other flap was transferred to cover the remnant wound and correct the malformation of cryptotia. Results All the patients were followed up from 6 months to 1 year with stable and symmetric appearance. Conclusions The shape of auricle is natural after operation without skin grafting. It is a simple and ideal method for the treatment of cryptotia.