全耳再造中改良颅耳角成形术的临床应用研究

目的探讨并评价改良颅耳角成形术在全耳再造中的应用及临床效果。方法 2012年9月至2014年6月,对161例先天性小耳畸形患者进行全耳再造。一期术后6个月行二期手术,采用改良颅耳角成形术完成颅耳角重建:人工骨材料作为支撑支架,耳后筋膜包裹支架,耳后枕部刃厚皮片植皮。结果本组患者术后随访6~18个月(平均12个月),151例患者术后颅耳角形态满意;10患者术后颅耳角瘢痕挛缩较明显,影响颅耳角角度。9例患者颅耳角植皮区下部色泽变深或出现表皮坏死,经换药处理后愈合良好。结论改良颅耳角成形术能较好地呈现满意的颅耳角结构。

Application of Modified Ear Elevation in Ear Reconstruction

Objective To investigate the application and effects of the modified ear elevation in ear reconstruction. Methods From Sep. 2012 to Jun. 2014, 161 cases with congenital microtia were received ear reconstruction. The modified elevation in second stage was performed 6 months after first-stage operation for auriculocephalic angle reconstruction. EH composite wedge was transplanted at the rear side of framework, then the homolateral postauricular fascial flap was used to cover the postauriclar-frame, finally split-skin graft were transplanted on the fascia surface. Results All patients were followed up for 6-18 months (mean 12 months). In 151 patients, reconstructed auriculocephalic angle was close to the normal side. In other 10 patients, severe scar contracture was observed. Darker epidermis or partial grafted skin necrosis (<1 cm 2) were observed in 9 cases, and were healed by dressing. Conclusion Modified ear elevation in second stage can achieve satisfactory structure of auriculocephalic angle.