耳后窄蒂皮下蒂皮瓣修复耳廓内软组织缺损

目的探讨应用耳后窄蒂皮下蒂皮瓣修复耳廓内软组织缺损的方法及疗效。方法 2008年6月-2011年7月,收治11例耳廓内肿物切除后软组织缺损患者。男7例,女4例;年龄26～75岁,平均50岁。其中色素痣5例,基底细胞癌2例,混合性血管瘤2例,皮肤乳头状瘤2例。病程3～50年,平均35年。彻底切除肿物后,软组织缺损范围为1.5 cm×1.0 cm～3.5 cm×3.0 cm。沿颞浅动脉及耳后动脉走向,设计耳后"乒乓球拍状"窄蒂皮下蒂皮瓣,通过隧道移位修复缺损,皮瓣切取范围1.8 cm×1.3 cm～3.8 cm×3.3 cm,蒂宽0.4～0.7 cm、长2～5 cm。供区直接拉拢缝合或局部皮瓣移位修复。结果术后供、受区皮瓣均顺利成活,切口均Ⅰ期愈合。术后8例获随访,随访时间6个月～1年。皮瓣质地、弹性、色泽良好,耳廓外形良好。肿瘤患者无复发。结论耳后窄蒂皮下蒂皮瓣蒂部窄长、旋转角度大、修复范围广、不含知名血管,手术操作简便,供区隐蔽,是修复耳廓内软组织缺损的理想方法之一。

Application of narrow hypodermal pedicled retroauricular flap in repairing preauricular soft tissue defect

Objective To investigate the technique and effectiveness of using narrow hypodermal pedicled retroauricular ap for repairing preauricular soft tissue defect.Methods Between June 2008 and July 2011,11 cases of preauricular soft tissue defect were treated,which were caused by resection of preauricular tumors,including 5 cases of pigmented nevus,2 cases of basal cell carcinoma,2 cases of mixed hemangioma,and 2 cases of skin papilloma.There were 7 males and 4 females,aged from 26 to 75 years(mean,50 years).The disease duration was 3-50 years(mean,35 years).The size of the soft tissue defect ranged from 1.5 cm × 1.0 cm to 3.5 cm × 3.0 cm.The narrow hypodermal pedicled retroauricular ap was designed with its pedicle along the pathway of the super cial temporal artery and posterior auricular artery through tunnel to repair the defects.The size of the aps ranged from 1.8 cm × 1.3 cm to 3.8 cm × 3.3 cm with the pedicle of 2-5 cm in length and 0.4-0.7 cm in width.The donor site was sutured directly or repaired with local ap.Results All aps survived and incisions healed primarily after operation.Eight cases were followed up 6 months to 1 year.The aps had good texture,exibility,and color,and the auricle appearance was satisfactory.No recurrence of tumor was found.Conclusion The narrow hypodermal pedicled retroauricular ap has long and narrow pedicle,big transferring angle,large repairing area,no major blood vessel,and easy operation,so it is a simple and ideal technique for repairing preauricular soft tissue defect.