两种扩张的筋膜皮瓣法耳再造的效果比较

目的:探讨比较两种扩张筋膜皮瓣(简称:A组单纯耳后扩张皮瓣;B组,耳后联合双层筋膜皮瓣)包裹支架行全耳廓再造术的临床方法和效果。方法:对先天性小耳畸形患者均采用Medpor为支架,分别行两种皮瓣方式覆盖支架。A组:30例行耳后乳突区单纯扩张皮瓣包裹支架;B组:38例行耳后双层联合筋膜皮瓣包裹支架行全耳再造术。结果:A组30例患者中,出现血肿者2例,出现皮肤破溃假体外露1例,经局部换药皮瓣转移后创面痊愈。B组联合双层扩张耳后筋膜皮瓣38例患者中,术后耳部轮廓清晰,再造耳轮,对耳轮、耳甲腔等精细结构显现。供区无需植皮,色差及瘢痕均不显。结论:两种方法比较均获得较好的临床效果。其中耳后联合双层筋膜皮瓣法更能显现再造耳的微细结构,避免假体外露,为临床首选的一种好方法。

Comparison of two kinds of expansion of the fascia flap ear reconstruction

Objective To compare two full-ear reconstruction methodologies which use the expansion of the fascia flap （Group A： Expansion of the ear flap;Group B：Joint double ear flap fascia） to cover the support. Methods Using Medpor on congenital microtia patients perform.two kinds of flaps to cover the support.Group A,30 cases used expanded flap of mastoid area behind the ear to wrap the support.Group B,38 cases used joint double ear flap fascia to wrap the support. Results In group A, 2 cases appeared hematoma and 1 case exposed support.The wounds were recovered after treatment.In group B, the reconstructed ears had lifelike appearance.Helix and ear cavity revealed fine structure.Reconstructed area appeared no significant color differences and scars. Conclusions The two methods presented both good effects.Especially the method of joint double ear flap fascia could avoid the exposed support and had lifelike ear structure.It is the ideal choice for full-ear reconstruction.