半侧颜面短小畸形患者耳郭再造的临床研究外科学专业论文.docxVIP

北京协和医学院硕士研究生学位论文Clinical 北京协和医学院硕士研究生学位论文 Clinical Research of Auricular Reconstruction in HemifaciaI Microsomia Abstract Objective：The purpose of this study is to research the clinical application of expanded two-flap method auricular reconstruction in patients with hemifacial microsomia, providing optimization auricular reconstruction technique for microtia patients with hemifacial microsomia． Methods：From January 20 1 4 to November 20 1 5，1 1 1 microtia patients with moderate and severe hemifacial microsomia were treated in our department．Of the 1 1 1 patients in this series，58 were right，53 were left．A total of 87 of the patients were male， and 24 were female，ranging in age from 5 to 27 years with an average of 9．2 years．The patients were treated by expanded two-flap method which includes three stages．In the first stage，the 50 ml kidney-shape tissue expander was implanted in the retroauricular mastoid region subcutaneously．In the second stage，the costal cartilage Was harvested and the framework was fabricated．After the expander was removed，the framework was enveloped by the expanded two-flap．In the third stage，tragus Was formed，lobule Was transposed and the concha was excavated． Results：The 1 1 1 patients were followed up for 5 to 20 months(in average 8．3 months)postoperative．1 03(92．8％)patients were satisfied with the operation，the size， position and auriculoccphalic sulcus of the reconstructed ear are similar to the normal ear with the clear and harmonious substructure，and there were no serious complications． However,7 patients were basically satisfactory,1 patient Was not satisfied witll the result． There were 9 complications in this series．Complications related to tissue expander implantation：2 cases嘶t11 hematoma，the expander were removed and hemostasis performed in the operating room；1 case with infection，the infection Was controlled by repeated washing the cavity wim 2％Iodine Tincture and alcoh01．Partial necrosis of the expanded flap occurred in 2 patient