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目的 探讨利用耳后扩张的袋状皮瓣行全耳再造术的效果。方法 1997年 12月至1999年 11月对 18例小耳畸形患者 ,应用耳后扩张袋状皮瓣行全耳再造术。手术分两期进行 :Ⅰ期手术在耳后皮下埋置 5 0ml肾形扩张器 ,同时行耳垂转移或旷置。Ⅱ期手术在扩张的耳后皮瓣上或下端经 2 .5～ 3.0cm切口切开取出扩张器 ,除前方为蒂部不予切开外 ,均在扩张皮瓣稍外侧约距扩张囊边缘 0 .5～ 0 .6cm处呈肾形切开直达深筋膜下层 ,由耳后筋膜深层向前锐性分离 ,形成一囊袋状一并掀起。袋内置入耳支架并固定、负压吸引、耳后全厚植皮修复。结果 用耳后扩张袋状皮瓣行全耳再造 ,简化了手术程序 ,增强了皮瓣的血液循环 ,提高了负压吸引效果 ,降低了并发症的发生率。临床应用 18例 ,效果较为满意。结论 耳后扩张袋状皮瓣全耳再造术成功率高 ,外形逼真。
Objective To explore the effect of auricular reconstruction using auricular dural flap. Methods From December 1997 to November 1999, 18 cases of small ear deformity were treated with auricle reconstruction. Surgery in two phases: Ⅰ surgery in the ear subcutaneous embedded 50ml kidney-shaped dilator, at the same time the line of earlobe transfer or exclusion. Ⅱ stage operation in the expansion of the posterior flap or lower extremity incision through the 2.5 ~ 3.0cm incision to remove the dilator, in addition to the pedicle is not cut, are slightly flared in the dilatation flap about the edge of the dilatation 0 .5 ~ 0 .6cm at the kidney-shaped incision directly to the deep fascia, from the ear fascia deep forward sharp separation, the formation of a bag-like set off. Bag built into the ear bracket and fixed negative pressure to attract, after the ear full thickness skin repair. Results The auricular reconstruction of the whole ear with auricular dilatation flap simplifies the surgical procedure, enhances the blood circulation of the flap, enhances the suction effect of the negative pressure and reduces the incidence of complications. Clinical application of 18 cases, the effect is more satisfactory. Conclusion Auricular reconstruction of auricular pocket flap with high success rate, realistic appearance.