成人小耳畸形的耳郭再造临床研究

Clinical study of auricle reconstruction of adult patients with microtia

目的探讨成年小耳畸形患者的耳郭再造方法和效果。方法收集85例成年小耳畸形患者,术前完善肋骨CT重建等检查,接受扩张器置入、肋软骨采集与支架移植、再造耳局部修整,共行三期手术。结果本组85例患者术后再造耳的色泽、质地、相对位置和精细结构较好,形态较逼真、立体感强、效果满意,术后随访2年见支架结构稳定,无变形和吸收现象出现。结论成年小耳畸形耳郭再造术较复杂,通过术前CT评估肋软骨情况,应用扩张皮瓣结合改良后的支架雕刻拼接,取得了较好的效果,值得进一步总结和临床推广。

Objective To explore the method and efficacy of auricle reconstruction in adult patients with microtia.Methods A total of 85 adult patients with microtia were enrolled in this study.Preoperative examinations including CT reconstruction of the ribs were performed before the operation.There were a total of three phases of the operations,including 1)placement of the expander,2)harvest of costal cartilage and transplantation of the framework,and 3)local repair of the reconstructed ear.Results The reconstructed ears in the85 adult patients with microtia had realistic auricle shape and good symmetrical appearance.Patients were satisfied with the color,texture,position,and detailed structures of the reconstructed ears.Two years of follow-up showed that the framework structure was stable,with no deformation or absorption.Conclusion Auricle reconstruction in adult patients with microtia is a complex surgical procedure.Preoperative evaluation of costal cartilage by CT and application of the expanded flap combined with an improved framework carving technique achieved good results.This surgical method is worthy of further summary and clinical promotion.