CAJ | 학술논문

目的探讨应用乳突区超量扩张皮瓣联合颞浅筋膜瓣包裹多孔高密度聚乙烯( Medpor)支架行全耳廓成形术的效果.方法手术分三期进行:第Ⅰ期在乳突区置入皮肤软组织扩张器,并超量注水扩张；第Ⅱ期将扩张器取出并形成蒂在前的扩张皮瓣、掀起以颞浅血管为蒂的颞浅筋膜瓣,应用乳突区超量扩张皮瓣与颞浅筋膜瓣联合由里至外包裹Medpor耳支架完成全耳廓成形术,第Ⅲ期为残耳处理及耳垂再造.结果临床应用12例,随访3个月至1年,耳支架外露发生1例,形成的耳廓外形逼真,轮廓分明,肤色与周围正常皮肤一致.结论应用乳突区超量扩张皮瓣与颞浅筋膜瓣双层组织瓣联合包裹Medpor耳支架,可以获得更多的皮肤面积并提高Medpor耳支架置入的安全性,避免发生外露,又不影响支架外形和轮廓的显现,制作的耳廓表面皮肤的色泽与周围皮肤一致.
목적 탐토응용유돌구초량확장피판연합섭천근막판포과다공고밀도취을희( Medpor)지가행전이곽성형술적효과.방법 수술분삼기진행:제Ⅰ기재유돌구치입피부연조직확장기,병초량주수확장；제Ⅱ기장확장기취출병형성체재전적확장피판、흔기이섭천혈관위체적섭천근막판,응용유돌구초량확장피판여섭천근막판연합유리지외포과Medpor이지가완성전이곽성형술,제Ⅲ기위잔이처리급이수재조.결과 림상응용12례,수방3개월지1년,이지가외로발생1례,형성적이곽외형핍진,륜곽분명,부색여주위정상피부일치.결론 응용유돌구초량확장피판여섭천근막판쌍층조직판연합포과Medpor이지가,가이획득경다적피부면적병제고Medpor이지가치입적안전성,피면발생외로,우불영향지가외형화륜곽적현현,제작적이곽표면피부적색택여주위피부일치.
Objective To investigate the feasibility and results of the application of both expanded cutaneous flap and temporoparietal fascia flap in total ear reconstruction with Medpor framework.Methods The main procedures consisted of three stages:stage Ⅰ-skin expansion,stage Ⅱ auricle formation that consisted of orientation of Medpor implant and creation of coverage for the implant by both expaned skin flap and temporoparietal fascia flap,and stage Ⅲ-treatment of residual ear and recontruction of auricular lobule. Results Twenty-two ears in 22 unilateral microtia patients were constructed using Medpor implants covered with both expanded cutaneous flap and temporoparietal fascia flap over the last three years,and they were accepted as pleasing by the patients.Conclusions Application of both expanded cutaneous flap and temporoparietal fascia flap can assure no extrusion of Medpor implant in ear reconstruction.Further more,the two layers of transferred tissues will not affect the profile details of the reconstructed ear.And because the skin covering the framework and fascia is derived from frommastoid region,the appearance and profile of the reconstructed auricle is true to nature and close to that of the opposite one.