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目的探讨运用超声等检测手段,对乳突区皮肤软组织特性进行评估,为符合条件的患者选择二期法(Nagata法)进行耳郭再造治疗。方法选择自2015年5月至2016年6月治疗的272例先天性小耳畸形患者,根据测量结果,将乳突区皮肤厚薄和松弛度分型为薄(0.09~0.14 cm)、中等(0.15~0.19 cm)、厚(2.00~2.40 cm);紧(0.50~0.70 cm),中等(0.80~1.00 cm),松(1.10~1.30 cm);根据分型组合得出评分。结果 106例评分≥3分患者采用二期法技术完成耳郭再造。术后平均随访5.8个月,89例(83.96%)患者及家属对再造耳郭形态非常满意;8例(7.50%)认为再造耳郭比较满意;3例(2.83%)对再造耳形态不满意。结论对先天性小耳畸形患者,可以通过乳突区皮肤条件具体量化后根据评分选择不同的手术方式,皮肤条件好的患者选择二期法耳郭再造,缩短了治疗时间,减少了皮瓣扩张的痛苦,再造耳郭形态良好,总体效果满意。
Objective To evaluate the characteristics of skin and soft tissue in mastoid area by ultrasound and other tests, and to choose the second stage method (Nagata method) for auricular reconstruction. Methods From July 2015 to June 2016,272 cases of congenital malformations were selected. According to the measurement results, the skin thickness and laxity of the mastoid area were classified as thin (0.09 ~ 0.14 cm), medium (0.15 ~ 0.19 cm), thickness (2.00-2.40 cm), tight (0.50-0.70 cm), medium (0.80-1.00 cm) and loose (1.10-1.30 cm). Results 106 patients with a score ≥ 3 points were treated with two-stage technique to complete the auricle reconstruction. The follow-up averaged 5.8 months. 89 (83.96%) patients and their families were very satisfied with the shape of the auricles. In 8 cases (7.50%) they were satisfied with the auricles. In 3 cases (2.83% . Conclusions In patients with congenital malformations of the ears, different surgical methods can be selected according to the scoring criteria after skin conditions are accurately quantified in mastoid region. Patients with good skin conditions are eligible for second-stage auricular reconstruction, which shortens the treatment time and reduces the expansion of the flap Pain, reconstruction ear shape, the overall effect is satisfactory.