耳廓复合组织瓣的三种术式修复鼻翼缺损的临床评价

目的根据患者鼻翼缺损的形态、自身条件和面容，选择一种简易、理想的耳廓复合组织瓣术式，使修复的鼻翼饱满，鼻孔对称，从而获得比较完美的鼻形。方法通过对5年来32例鼻翼缺损修复中的26例进行随访，比较不同耳廓复合组织移植术式的优缺点、术中注意点，找出各种鼻翼缺损的合适术式。结果3种耳廓复合组织瓣术式修复鼻翼缺损的随访优良率，差异不具有显著性意义。结论3种耳廓复合组织瓣术式修复鼻翼缺损外形均良好，重要的是选择好手术适应证。游离耳廓复合组织瓣修复鼻翼缺损术式简便易行，面部不增加新的瘢痕；眶上动脉供血的反流轴型岛状耳廓复合组织瓣修复鼻翼缺损的术式，修复鼻翼缺损范围大，但受血管条件限制；吻合血管的游离耳廓复合组织瓣修复鼻翼缺损，修复后鼻槛及外侧壁形态好，但操作难度大。

Alar reconstruction by different methods of composite ear transplantation:a clinical evaluation

Objective To select a simple and suitable operation metho d of composite ear transplantation according to the feature of alar defection an d personal characteristics, which can lead to a perfect reconstructional result with plump ala and symmetric nostril. Methods Evaluation standa rds, practical situation, attentions in operation, advantages and disadvantages of 3 methods of composite ear transplantation were determined from the follow-u p results in 26 out of 32 alar reconstruction cases in recent 5 years. R esults No obvious difference was found out of the results of the 3 meth ods of composite ear transplantation. Conclusions All the 3 met hods of composite ear transplantation are effective. Composite ear graft is simp le, with no further scar formation on face. Refluent axil ear flap pedicled by s upraorbital artery is suitable to bigger defection but the transplantation is re stricted by vessel condition. Composite ear flap transplantation with vessels an astomoses can reach a satisfactory result but the operation is complex. It is im portant to get a satisfactory reconstructive result that a suitable method is se lected according to the features of alar defection and personal characteristics.