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目的设计逆行颞浅血管蒂的游离耳廓组织瓣,探索应用显微外科技术修复鼻部分缺损的新手术方法。方法切取以颞浅血管远端为蒂的耳廓复合组织瓣,应用显微外科技术将颞浅动、静脉远端与面动静脉吻合游离移植修复部分鼻缺损15例,其中鼻翼修复13例,鼻尖修复2例。组织瓣的大小范围为2·5cm×2·0cm~4·0cm×2·5cm,血管蒂的长度为5~8cm,平均6·5cm。结果15例患者游离移植的耳廓复合组织瓣全部成活,重建的鼻翼与健侧对称、鼻尖外形美观。耳廓供区不遗留明显畸形。结论吻合血管的逆行颞浅动脉耳廓复合组织瓣游离移植,血管蒂长,克服了顺行耳廓复合组织瓣血管蒂过短的问题,可成为颞浅动脉耳廓复合组织瓣设计的首选术式。
Objective To design a free auricular tissue flap of retrograde temporomandibular pedicel and explore a new surgical method of using microsurgery to repair nasal defect. Methods The auricular compound tissue flap pedicled with the distal temporal superficial blood vessels was dissected. Fifteen cases of partial nasal defect were repaired by anastomosing the distal superficial temporal artery and the facial arteriovenous vein with microsurgical technique. Among them, Nasal tip repair in 2 cases. Tissue flap sizes ranged from 2.5 cm x 2.0 cm to 4.0 cm x 2.5 cm. The length of the vessel pedicle was 5-8 cm with an average of 6.5 cm. Results The auricular compound tissue flaps of all the 15 patients survived successfully. The reconstructed nasal and contralateral sides were symmetrical and the appearance of the nose tip was beautiful. Pinna for the area does not leave obvious deformity. Conclusions The transvaginal transversal superficial temporal artery with compound aortic valve flap transplantation is free and the vessel length is long, which overcomes the problem of too short vessel pedicle of the auricular canal. It can be the first choice for the design of auricular compound tissue flap of the superficial temporal artery formula.