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目的:探讨使Ⅰ期全耳廓再造术能获得较理想外形和取材方便的支架材料。方法:对30例先天性全耳廓缺损患者行Ⅰ期全耳廓再造术,耳廓支架材料采用自体肋软骨10例,组织代用品Medpor支架20例。结果:术后随访6个月～3年,再造耳均成活。但采用肋软骨的10例手术范围大,软骨加工成支架外形不理想,难以雕刻,成活后再造耳廓外形欠满意,微细结构欠清晰,且取肋软骨的部位胸廓易出现畸形、气胸等并发症。而20例采用Medpor作为耳支架者再造耳成活后,耳廓外形逼真,有韧性,手术加工皆较容易,手术范围小,无并发症。结论:说明全耳廓再造术中耳廓支架材料采用Medpor是较为理想的组织代用品。
OBJECTIVE: To explore the scaffold materials that can make the shape and material drawing easier for stage Ⅰ total auricle reconstruction. Methods: Thirty cases of congenital total auricular defect were treated with stage Ⅰ total auricle reconstruction. Ten cases of auricular scaffold were treated with autologous rib cartilage and 20 cases of tissue substitute Medpor scaffold. Results: The patients were followed up for 6 months to 3 years and the ears were alive. But the use of costal cartilage 10 cases of large surgical range, cartilage into the shape of the stent is not ideal, difficult to engraving, surviving reconstruction ear shape less satisfactory, the microstructure is not clear, and the site of costal cartilage prone to deformity, pneumothorax and other complications disease. The 20 cases of Medpor as a scaffolding recipients living ear reconstruction, the ear shape lifelike, toughness, surgical treatment are easier, a small range of surgery, no complications. Conclusion: It is an ideal tissue substitute to use Medpor for auricle scaffold in total auricle reconstruction.