预制扩张耳后乳突区复合筋膜皮瓣在全耳再造中的应用研究

目的：研究采用预制扩张耳后乳突区复合筋膜皮瓣行全耳廓再造的方法和效果。方法：手术分二期完成。I期手术：设计带有颞浅动静脉蒂的颞顶筋膜瓣,移植入残耳乳突区皮下腔穴,然后置入皮肤扩张器,与耳后皮瓣进行同时同步扩张I;I期手术：将预制扩张的耳后乳突区复合筋膜皮瓣掀起,覆盖于Medpor支架上,进行全耳廓再造术。结果：36例患者经6个月～3年的随访,再造耳廓外形逼真,立体感强,与周围皮肤颜色相同,微细结构清晰。结论：采用预制扩张的耳后乳突区复合筋膜皮瓣＋Medpor支架行全耳再造,具有创伤小,操作方便,效果满意。既可避免支架外露,又可避免取自体肋软骨增加的创伤和痛苦或肤色差异等优点,是目前全耳廓再造术较为理想的选择方法。

Study on the application of compound temporoparietal fascia flap of pre-expansion mastoid area for full ear reconstruction

Objective Study on the method and effect of compound temporoparietal fascia flap of pre-expansion mastoid area for full ear reconstruction.Methods Surgery has two stages.I Design the superficial temporal artery and vein pedicled temporal fascial flap,transplant into the subcutaneous cavity of residual ear,insert tissue expander.II lift compound temporoparietal fascia flap of pre-expansion mastoid area,cover the Medpor and reconstruct the full-ear.Results Within 6 month to 3 years visiting for 36 cases,reconstructed ears have lifelike appearance,dimension,the same color as the surrounding skin and fine structure.Conclusions This method is easy and satisfied,with less trauma and good shape.It is an ideal choice for full-ear reconstruction as it can avoid the support exposed,the trauma and pain,and skin color differences.