应用扩张的颞部瘢痕皮瓣＋Medpor耳支架行全耳郭再造

目的 探讨利用扩张的颞部瘢痕轴型皮瓣＋ Medpor耳支架行全耳郭再造的效果.方法 自2005年1月至2010年12月,共收治3例患者,均为男性;年龄22～ 30岁.头面部均为火焰严重烧伤并遗留颞部萎缩性瘢痕,同侧残耳皱缩、形态消失.采用Ⅰ期瘢痕头皮下置入皮肤软组织扩张器,注水扩张过程完成后,Ⅱ期行携带颞浅动静脉血管的颞部瘢痕轴型皮瓣＋Medpor耳支架方法行全耳郭再造.结果 3例手术均成功,虽然出院时耳郭臃肿,形态不明显,但术后随访6～12个月,扩张的瘢痕皮瓣已调整,再造塑形耳外形轮廓良好.结论 利用扩张的颞部瘢痕轴型皮瓣＋Medpor耳支架行全耳郭再造,效果良好,但遗留瘢痕外观为其不足.

Reconstruction of total auricular with expanded temporal scar flap and Medpor ear scaffold

Objective To study the effect of the expanded temporal scar flap and Medpor ear scaffold on total auricular reconstruction.Methods From Jannary 2005 to December 2010,the beads and faces on 3 male patients aged 22 to 30 years old were badly burned by flame leading to temporal atrophic scar,ipsilateral residual ear shrinkage and morphology disappearance.The skin soft tissue expander was placed under the scalp with scar primarily.Phase two,after the expansion process was completed by water injection,the Medpor support and the temporal scar axial-pattern flap pediceled superficial temporal artery and vein were used to perform the whole auricle reconstruction.Results All three cases were successful.Although the auricle was bloated and its morphology was not obvious at the time of discharge,but after 6 to 12 months following up,the expended scar skin flap had been adjusted with good reshaped auricle.Conclusion It showed that using the expanded temporal scar axial-pattern flap and Medpor support to make the whole auricle reconstruction could achieve good results,but the remaining scar appearance was its shortcoming.