皮肤扩张法结合自体肋软骨支架治疗重度杯状耳畸形.docVIP

皮肤扩张法结合自体肋软骨支架治疗重度杯状耳畸形 　　[摘要]目的：探讨采用皮肤扩张法结合自体肋软骨支架治疗重度杯状耳畸形的效果。方法：采用皮肤扩张法结合自体肋软骨支架三期法治疗重度杯状耳畸形患者共16例（16只耳）。第一期手术耳后置入50～80ml扩张器，注水扩张3个月，第二期手术切取自体肋软骨，雕刻组合成三维立体软骨支架，用扩张皮瓣包裹支架形成耳廓。3个月后，杯状耳转位与再造部分衔接，完成重度杯状耳畸形的修复。结果：1例患者第三期术后出现软骨支架外露，经换药后愈合。其余15例无并发症发生。再造的耳廓外形良好，结构清晰，双侧耳廓对称。结论：采用扩张法结合自体肋软骨支架治疗重度杯状耳畸形，能够提供足够的皮肤及软骨量，是矫正杯状耳畸形的一种较好的手术方法。 　　[关键词]杯状耳；皮肤扩张法；肋软骨支架；耳廓再造 　　[中图分类号]R622.1[文献标识码]A[文章编号]1008-6455（2014）08-0621-04 　　 　　Correction of severe cup ear using skin expansion combined with autologous rib cartilage framework 　　YANG Yun,WANG Lu,WANG Ji-hua,ZHANG Yin-jia,TANG Ting,GUO Qun,ZHU Li-kun, 　　ZHANG Jing-bo 　　(Department of Plastic Surgery,The Second Affiliated Hospital of Kunming Medical University,Kunming 650001,Yunnan,China) 　　 　　Abstract: Objective To explore operative effects of using the skin and soft tissue expansion combined with autologous rib cartilage treat severe cup ear malformation.Methods 16 cases(16 ears) used skin expansion combined with autologous rib cartilage to correct sever cup ear deformity.The operation need to be done 3 stages. First stage, an 50～80ml expander was implanted under retroauriclar facia in mastoid area. Injecting water and expand for 3 months.The second stage operation, two or three rib cartilages were harvested and the frame work was fabricated,and covered with expanded flap.Three months later, the cup ear was transfered and linked up with reconstructed auricle.ResultsA total of 16 cases (16 ears), exposure of rib cartilage occured in 1 case, the wound healed after dressing. The other patients without complication, have good auricle appearance and structure clear, bilateral auricles symmetry. Conclusion This method could supply enough skin and cartilage to correct severe cup ear deformity, is a better surgical method. 　　Key words:cup ear;skin expansion;rib cartilage framework;auriclar reconstruction杯状耳是一种介于招风耳和小耳之间的先天性畸形，约占各种先天性耳畸形的10%。双侧性较多见[1]。杯状耳根据畸形程度分为轻、中、重度。轻中度畸形只是耳轮折叠、前倾，重度杯状耳耳廓位置较健侧低,高度较对侧低1～2cm；耳廓体积偏小；耳廓上份发育不良