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耳廓上部外伤性缺损的修复

Repair of traumatic defects in upper auricle
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摘要 目的探讨不同类型耳廓上部缺损手术修复方法。方法回顾性分析空军军医大学西京医院整形外科2020年1月至2022年12月收治的耳廓上部缺损患者共10例,根据患者缺损情况、局部皮肤条件,选择两种不同修复方案。对于仅皮肤缺损伴少量耳软骨缺损的患者选用耳后皮瓣修复;对于缺损严重、涉及多个耳廓解剖亚单位的患者,采用皮肤软组织扩张+自体肋软骨部分耳再造修复,Ⅰ期于耳后置入皮肤软组织扩张器,Ⅱ期行自体肋软骨取出、扩张皮瓣转移部分耳廓再造术,Ⅲ期行耳廓部分再造术后局部修整术。结果本组共10例患者,耳后皮瓣修复6例,分期部分耳再造法4例。随访时间3~18个月。患者术后均无血肿形成、感染、皮瓣坏死、严重瘢痕增生等并发症,耳廓形态自然,患者满意。结论根据耳廓上部缺损情况选择合适的修复方法,可取得良好的修复效果。 Objective To explore the surgical repair methods of different types of upper auricle defects.Methods A total of 10 cases of upper auricle defects treated in Department of Plastic Surgery,Xijing Hospital,Air Force Medical University from January 2020 to December 2022 were retrospectively analyzed.According to the defects and local skin conditions of patients,two different repair methods were selected.The patients with only skin defects and a small amount of ear cartilage defects were treated with posterior auricular flap.For patients with severe defects involving multiple anatomical subunits of the auricle,skin soft tissue expansion and autologous costal cartilage were used for staged partial ear reconstruction.In the first stage,a skin soft tissue expander was inserted in the posterior ear area;in the second stage,autologous costal cartilage harvesting,expanded skin flap transferring and partial auricle reconstruction were performed;and in the third stage,the partial reconstructed auricle was trimmed and adjusted for a better appearance.Results There were 10 cases in this group,including 6 cases with posterior auricular flap and 4 cases with staged partial ear reconstruction.The follow-up period was 3 to 18 months.There were no complications such as hematoma formation,infection,flap necrosis and severe scar hyperplasia.The auricle shape was good and the patients were satisfied.Conclusion Selecting suitable repair methods according to the condition of upper auricle defects can obtain a good repair effect.
作者 陈永军 魏思明 郝冬月 夏文森 马显杰 董立维 CHEN Yongjun;WEI Siming;HAO Dongyue;XIA Wensen;MA Xianjie;DONG Liwei(Department of Plastic Surgery,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)
出处 《空军军医大学学报》 CAS 2024年第8期903-906,共4页 Journal of Air Force Medical University
基金 国家自然科学基金面上项目(82172229)。
关键词 耳廓缺损 耳后皮瓣 扩张法耳再造 肋软骨支架 auricular defects posterior auricular flap ear reconstruction by tissue expansion costal cartilage framework
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