二期法耳郭再造皮肤条件的具体量化

Quantitative analysis of skin condition for two-stage auricular reconstruction

目的探讨运用超声等检测手段,对乳突区皮肤软组织特性进行评估,为符合条件的患者选择二期法(Nagata法)进行耳郭再造治疗。方法选择自2015年5月至2016年6月治疗的272例先天性小耳畸形患者,根据测量结果,将乳突区皮肤厚薄和松弛度分型为薄(0.09~0.14 cm)、中等(0.15~0.19 cm)、厚(2.00~2.40 cm);紧(0.50~0.70 cm),中等(0.80~1.00 cm),松(1.10~1.30 cm);根据分型组合得出评分。结果 106例评分≥3分患者采用二期法技术完成耳郭再造。术后平均随访5.8个月,89例(83.96%)患者及家属对再造耳郭形态非常满意;8例(7.50%)认为再造耳郭比较满意;3例(2.83%)对再造耳形态不满意。结论对先天性小耳畸形患者,可以通过乳突区皮肤条件具体量化后根据评分选择不同的手术方式,皮肤条件好的患者选择二期法耳郭再造,缩短了治疗时间,减少了皮瓣扩张的痛苦,再造耳郭形态良好,总体效果满意。

Objective To evaluate the skin and characteristics of the soft tissue in the mastoid regionby means ofultrasonography,and,for eligible patients,with two-stage auricular reconstruction （Nagata method）.Methods From May 2015 to June 2016,a total of 272 patients with congenital microtia were selected for the study.Patients were divided into treatment groups according to the condition of the skin in the mastoid area.Patients were divided into at hin skin group （0.09 cm to 0.14 cm）,a mediumgroup （0.15 cm to 0.19 cm）,anda thickgroup （2.00 cm to 2.40 cm）,according to skin thickness.They were also divided into a tight group （0.50 cm to 0.70 cm）,medium group （0.80 cm to 1.00 cm）,and loose group （1.10 cm to 1.30 cm）,according to skin laxity.The scores were recorded.Results Two-stage auricular reconstruction was performed in 106 patients.Scoresexceeded 3.The average follow-up was 8.8 months.Eighty-nine patients （83.96%） and their families were satisfied with the results.Eightpatients （7.50%） felt relative satisfaction and 3 patients （2.83%） were unsatisfied with the results.Conclusion Different surgical approaches can be selected according tosoft tissue condition scores,as tested by ultrasonic analysis.Two-stage auricular reconstruction can be used in patients with good skin condition.This method can shorten treatment time and reduce the pain of flap extension.The reconstructed auricle has a good shape and can achievesatisfactory results.