第8肋软骨发育异常的小耳畸形改良Nagata法耳再造一期外耳轮支架拼接技巧

Splicing of helix framework in modified Nagata's method stageⅠfor auricle reconstruction with 8th rib cartilage dysplasia

目的探索改良Nagata法肋软骨耳再造一期外耳轮支架拼接技巧。方法自2022年9月至2023年5月,中国医学科学院北京协和医学院整形外科医院外耳整形再造二科行改良Nagata法一期手术治疗17例第8肋软骨异常的小耳畸形患者,因第8肋长度不足以构建完整外耳轮,在雕刻外耳轮支架时,采用条形软骨行斜面楔形拼接。结果17例患者术后再造耳形态逼真、立体感强,各个亚结构清晰可见。外耳轮拼接处过渡平顺,拼接点显露不明显。所有患者经随访至二期手术前(一期术后3~6个月)支架稳定,无变形和吸收,远期随访仍在观察。结论在改良Nagata法一期手术中,当第8肋软骨长度不足时,采用条形软骨斜面楔形拼接的方式效果稳定,再造耳形态良好。

Objective To investigate an improved technique for splicing of helix framework in patients with dysplasia of 8th rib cartilage.Methods From September 2022 to May 2023,17 patients with congenital microtia and dysplastic 8th rib cartilage who underwent auricular reconstruction with modified Nagata's stage I technique were reviewed retrospectively.Due to the insufficient length of the8th rib to construct a complete outer helix framework,cartilage was spliced to the 8th rib cartilage wedged to create the helix framework.Results A total of 17 patients with unilateral congenital microtia,were analyzed with a follow-up period of 3 to 6 months after stage I of Nagata's technique.All patients had satisfied short-term outcomes.None of the patients had a visible splicing point under the grafted skin.None of the patients demonstrated any necrosis of the skin or absorption of the helix framework.Conclusion By splicing the cartilages,our technique can provide enough materials for microtia patients with dysplastic 8th rib,which might contribute to better outcomes for this group of patients.