耳廓掀翻入路的显微解剖与临床应用

目的：报道耳外科新的手术入路的显微解剖与临床应用。方法：在38侧标本上对外耳血供进行解剖观察，设计了耳廓向下掀翻入路，应用于121例耳部疾患。结果：外耳血供来自颈外动脉的颞浅动脉和耳后动脉，其外侧面为颞浅动脉上、中、下耳支及耳后动脉耳廓支的穿支供应，背面为耳后动脉上、中、下耳支供应。经耳廓掀翻中耳乳突手术入路，手术野大，暴露好，未发生耳廓缺血坏死或感觉障碍。结论：耳廓掀翻是现代耳外科理想的手术进路。

Microdissection and clinical application of unfolding approach of earlap

Objective: To provide a new operative incision for aural surgery. Methods: The blood supply of external ear was observed and dissected on 38 specimens, and then the downward unfolding approach of earlap was adopted to 121 patients suffering from aural region disease. Results: The origins of blood supply of external ear were as follows: arteria temporalis superficialis and posterior auricular artery derived from external carotid artery. The upper, middle and inferior auricular branches of arteria temporalis superficialis and perforating branches of auricular branch of posterior auricular artery supplied the lateral surface of earlap, while the upper, middle and inferior auricular branches of posterior auricular artery supplied the dorsal surface of it. The operative approach of unfolding middle ear and mamillary process through earflap had large clinical operating field of vision and good exposure, and there were no ischemic necrosis or sensory disability of earflap had ever happened. Conclusions: Unfolding approach of earlap is ideal for modern aural surgery.