耳后皮肤扩张术后前后双蒂皮瓣联合肋软骨支架修复外伤性部分耳郭缺损.docVIP

耳后皮肤扩张术后前后双蒂皮瓣联合肋软骨支架修复外伤性部分耳郭缺损[摘要]目的：介绍一种耳后皮肤扩张术后，采用前后双蒂皮瓣联合肋软骨支架植入修复外伤性部分耳郭缺损的方法。方法：手术分两期进行，一期在耳后埋置扩张器并进行扩张；二期手术以自体肋软骨雕刻合适大小的支架，利用扩张皮肤形成前后双蒂皮瓣，植入软骨支架后与残余软骨缝合。结果：临床应用8例患者，均愈合良好，外形满意，双耳基本对称。结论：耳后皮肤扩张术后采用前后双蒂皮瓣联合肋软骨支架修复外伤性部分耳郭缺损，适合于绝大多数外伤性部分耳郭缺损的患者，方法简单，效果良好、可靠。 [关键词]耳郭缺损；肋软骨支架；皮肤扩张术；前后双蒂 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）06-0829-03 Repair of part auricle defect after trauma by costal cartilage framework inserting and anterior-posterior pedicles skin flap overlaying after skin expansion behind ear LV Yuan-dong,CHEN Wei-hua,SHANG Yong (Department of Plastic and Cosmetic Surgery,First Affiliated Hospital of Harbin Medical University , Harbin，150001,Heilongjiang, China) Abstract： ObjectiveTo introduce a method of repairing part auricle defect after trauma by costal cartilage framework inserting and anterior-posterior pedicles skin flap overlaying after skin expansion behind ear.MethodsThe operation was divided into two stages. In the first stage, the expander was implanted in the mastoid region behind the ear and expanded. In the second stage, suitable curved autologous costal cartilage framework was implanted and sutured with remnant ear cartilage, and then overlayed by anterior-posterior pedicles skin flap.ResultsEight cases had been performed clinically with good healing, satisfactory shape and harmonious symmetry.ConclusionThe method of costal cartilage framework inserting and anterior-posterior pedicles skin flap overlaying after skin expansion behind ear was suitable for most patients of part auricle defect after trauma. It was a simple, good and reliable method. Key words: auricle defect；costal cartilage framework；skin expansion; anterior-posterior pedicles 耳郭是头颅外露突出的部分，易受各种原因的损伤而导致部分缺损，影响患者容貌美观。我科从2000年～2007年，应用耳后皮肤扩张、前后双蒂皮瓣结合肋软骨支架植入修复外伤后部分耳郭缺损，取得了良好的效果。 1临床资料 本组共8例，年龄17～58岁；其中男性6例，女性2例；左耳6例，右耳2例；车祸外伤4例，人咬伤4例。其中耳郭上1/3缺损4例，中1/3缺损4例。缺损面积为2～3.5cm2。耳郭缺损处有不同程度瘢痕形成，乳突区皮肤及耳颅角基本正常。 2手术方法 手术分为两期进行。前后双蒂皮瓣及扩张情况如图1。 2.1 一期：手术在局麻