自体肋软骨支架在小耳畸形耳再造术中的应用

Application of autogenous costal cartilage scaffold in reconstruction of small ear deformity ear

目的探讨自体肋软骨支架在小耳畸形耳再造术中的应用效果及制作技巧。方法选取2016年1月至2019年1月在我院实施小耳畸形再造术患者41例,均为Ⅱ型或Ⅲ型小儿畸形,所有患者均实施耳后皮肤扩张加自体肋软骨支架耳廓再造术。一期手术为残耳后置入皮肤扩张器,注水扩张;二期手术为取自体软肋骨(一般为6、7肋)进行雕刻修复,制作三维立体耳廓支架进行耳廓再造术,放置负压引流管,随访3至6个月,观察再造耳廓三维立体形态及颅耳角形成情况。结果41例小耳畸形患者再造耳廓三维立体形态良好,耳廓位置正常,颅耳角度适中,耳轮及三角窝结构良好,双侧对称良好,患者及家属对耳廓再造效果满意。结论自体肋软骨是耳廓再造的良好支架,通过高效、精心的雕琢拼接,可形成良好的三维立体耳廓结构,结合前期皮瓣扩张可得到良好的术后外观效果,是目前耳再造术的适宜方法。

Objective To explore the application effect and production skills of autologous costal cartilage scaffold in the reconstruction of small ear deformity ear.Methods Forty-one patients with small ear deformity reconstruction were enrolled in our hospital from January 2016 to January 2019.All patients were type II or type III pediatric malformations.All patients underwent postauricular skin expansion plus autologous costal cartilage stent auricle reconstruction.The first stage operation is to insert the skin dilator after the residual ear,and the water is dilated;the second stage operation is to take the self-soft ribs(usually 6,7 ribs)for engraving and repair,and to make a three-dimensional auricle support for auricle reconstruction,and place the negative The drainage tube was followed up for 3 to 6 months,and the three-dimensional morphology of the reconstructed auricle and the formation of the cranial angle were observed.Results The reconstructed auricles of 41 patients with small ear deformity had good three-dimensional shape,normal auricle position,moderate angle of the cranial ear,good structure of the ear wheel and the triangular socket,and good bilateral symmetry.The patient and family members were satisfied with the reconstruction of the auricle.Conclusion Autologous costal cartilage is a good scaffold for auricle reconstruction.It can form a good three-dimensional auricle structure through efficient and meticulous splicing and splicing.It can be used in combination with the early flap expansion to obtain a good postoperative appearance.It is suitable for current ear reconstruction.method.