耳廓复合组织瓣游离移植修复先天性鼻翼缺损.docVIP

耳廓复合组织瓣游离移植修复先天性鼻翼缺损[摘要]目的:探讨用自体耳廓游离组织瓣修复先天性鼻翼缺损的方法和效果。方法:切取同侧耳廓全层楔形复合组织瓣,插入鼻翼缺损区,牢固固定,供区拉拢缝合。结果:自2006年以来,应用该方法修复先天性鼻翼缺损畸形8例,缺损最大面积1.6cm×1.4cm,最小面积1.3cm×1.1cm。均取得了良好的效果,随访1～4年,耳廓组织瓣收缩小于10%。结论:应用自体耳廓复合组织瓣游离移植修复先天性鼻翼缺损可以较好地恢复鼻翼形态,仔细地形成鼻侧衬里,阶梯状耳廓复合组织瓣的形成,局部良好的固定是手术成功的关键。 [关键词]耳廓复合组织瓣;鼻翼缺损;修复 [中图分类号]R622 [文献标识码]A[文章编号]1008-6455(2010)09-1298-03 Repairing congenital alae ansi defects with auricle combination tissues HE Cheng-jun1,CUI Zi-wei1,LIUShi2,LI Hong-yan1,CUI Hong-ying3 (1.Department of Plastic Surgery, 2. Department of Ear-nose-throat, 3.Minor Operation Room. DaqingOilfield Ceneral Hospital,Daqing 163001,Heilongjiang,China) Abstract:ObjectiveTo discuss the method effect of rapairing congenital alae nasi defects with autoauricular free tissues.MethodsWe performed wedge-shaped excision of auricle combination tissue, then inserted it into the alae nasi defect areas, fixed stablely, donor sites were sutured.Results8 patients with congenital alae defects have recepted this treatments since 2006. The maximum defect area was 1.6cm×1.4cm and minimum was 1.3cm×1.1cm. Over 1～4 years follow-up,all patients had satisfactory results.The volume of auricle combination tissues reduced less than 10%.ConclusionsApplication of autoauricular free tissues for repairing congenital alae nasi defect could properly restore the shape of nasal alae.The key of success is the forming of nasal lateral lining and ladder-shaped auricle combination tissues. Key words:extensive auricle combination tissues; alae nasi defect; repairing 先天性鼻翼缺损的修复方法可根据鼻翼缺损的程度采取不同的手术方法[1]。笔者自2006年1月～2008年12月,采用自体耳廓游离组织瓣修复先天性鼻翼缺损8例,取得了较好的效果,报道如下。 1临床资料 本组共8例,年龄16～24岁,男性6例,女性2例,均为先天性鼻翼全层缺损,无既往治疗史。缺损宽度为1.3cm～1.6cm,高度为1.1cm～1.4cm,缺损最大面积1.6cm×1.4cm, 最小面积1.3cm×1.1cm。均采用自体全层耳廓复合组织瓣游离移植修复。 2手术方法 2.1 画线:用无菌X线片剪成与鼻翼缺损大小、形态一致的模型,根据模型在同侧耳轮上部处画线,长宽应扩大10%。 2.2 麻醉:采用同侧眶下神经阻滞麻醉和0.25%利多卡因(不含肾上腺素)供区、受区局部浸润麻醉。 2.3 鼻翼缺损区衬里的形成:在鼻翼缺损区皮肤缘处切开,剥离向内侧翻转,缝合线结打在鼻腔侧,尽可能增加两侧衬里的接触面积,可以形成缺损区上部衬里。 2.4 切取耳廓复