耳后皮下组织蒂皮瓣在耳前缺损修复中应用.docVIP

耳后皮下组织蒂皮瓣在耳前缺损修复中应用[摘要]目的：介绍耳后皮下组织蒂皮瓣在耳前缺损修复中的应用。方法：2006年5月～2010年10月间，应用耳后皮下组织蒂皮瓣修复耳前缺损32例。于耳后及乳突区设计耳后皮下组织蒂皮瓣，按设计线切开皮肤，自皮瓣远端开始向周围潜行分离形成皮瓣，旋转修复耳前缺损。结果：应用此法修复耳前缺损32例，切口均Ⅰ期愈合，皮瓣全部成活，术区平整，耳部形态满意，远期瘢痕不明显。结论：耳后皮下组织蒂皮瓣修复耳前缺损，方法简单，手术效果肯定，能达到良好的美学效果，是一种较理想的修复方法。 [关键词]耳后皮瓣；皮下组织蒂皮瓣；耳前缺损；修复 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）09-1345-03 Application of subcutaneous pedicle postauricular flap in preauricula defects repair WANG Jiang-yun,CHU Yu-hui,ZHANG Zhi-feng,MENG Yan-lin,HE Xing-hua,FENG Shu-xian,ZHOU Shi-hua (Department of Otolaryngology,The Third People’s Hospital of Zhengzhou,Zhengzhou 450000,Henan,China) Abstract:ObjectiveTo evaluate the application of subcutaneous pedicle postauricular flap in preauricula defects repair.MethodsFrom May 2006 to October 2010,the subcutaneous pedicle postauricular flap was designed to ripair preauricula defect in 32 patients.The subcutaneous pedicle postauricular flap was designed in postaur and mastoid region and the skin was cut along the designed line.We undermined the flap distal end and outwards to form a subcutaneous pedicle postauricular flap,then rotated the flap to cover the preauricula defects.Results32 cases with preauricula defects were repaired with subcutaneous pedicle postauricular flap. All the flaps survived and cosmetic results were satisfactory without visible scar.ConclusionIt is a simple and reliable method to repair thepreauricula defects with satisfied esthetic results. Key words:postauricular flap; subcutaneous tissue pedicle flap; preauricula defects;repair 头面部是体现人体外貌美与丑的最重要部位，修复头面部软组织缺损的方法对美学要求很高。由于耳廓位于头颅两侧的暴露部位，一旦发生缺损或者局部畸形，会对患者造成严重的心理负担。所以，对于缺损的修复，需要兼顾可操作性和美学的要求[1]。采用耳后皮下组织蒂皮瓣修复是一种较好的修复方法。2006年5月～2010年10月间，我科应用此方法修复耳前缺损32例，术后皮瓣全部成活，局部组织器官无明显变形，远期观察瘢痕不明显，效果良好。 1资料和方法 1.1 临床资料：本组患者共32例，男性20例，女性12例；年龄15～65岁，平均30岁。病因为：色素痣23例，肿瘤9例。切除肿物后遗留的缺损大小为1.0cm×1.0cm～2.0cm×3.0cm。 1.2 手术方法 1.2.1 肿物切除及皮瓣设计：采用局麻或全身麻醉。切口距病变边缘的距离：色素痣为1～2?；基底细胞癌和鳞状细胞癌为5～6?。设计耳后皮瓣的范围，其面积比耳前缺损稍大。蒂可位于上方或下方，取决于耳前缺损的位