中华耳科学杂志
中華耳科學雜誌
중화이과학잡지
CHINESE JOURNAL OF OTOLOGY
2014年
1期
90-92
,共3页
苏法仁%丁静华%薄琳%刘新刚
囌法仁%丁靜華%薄琳%劉新剛
소법인%정정화%박림%류신강
先天性小耳畸形%自体肋软骨支架%外耳再造皮肤软组织%扩张器%数字化技术
先天性小耳畸形%自體肋軟骨支架%外耳再造皮膚軟組織%擴張器%數字化技術
선천성소이기형%자체륵연골지가%외이재조피부연조직%확장기%수자화기술
Microtia%Autogenous cartilage framework%Auricle reconstruction%Skin soft tissue expansion%Digital technology
目的:探讨先天性小耳畸形的耳廓再造与重建方法。方法2003年1月至2012年12月,采用皮肤软组织扩张法,利用健耳相片,通过计算机photoshop软件数字化翻转处理形成即要再造耳廓的相片,然后进行耳廓软骨支架的雕刻,用扩张后的患耳乳突区皮瓣覆盖雕刻的自体肋软骨耳廓支架行耳廓再造。结果1102例(1165耳)经过6个月~10年的随访观察。其中56例(56耳)再造耳廓有不同程度的软骨吸收、变形;2例(2耳)肋软骨支架感染、肋软骨液化、坏死;1044例(1107耳)再造耳廓与健耳匹配,凹凸结构显示清晰,形状相似、逼真,颅耳角的角度与健耳对称。结论用皮肤软组织扩张法行耳廓再造,术中应用数字化技术形成患耳相片指导自体肋软骨耳廓软骨支架的雕刻,效果满意、并发症少,是先天性小耳畸形较好的治疗方法。
目的:探討先天性小耳畸形的耳廓再造與重建方法。方法2003年1月至2012年12月,採用皮膚軟組織擴張法,利用健耳相片,通過計算機photoshop軟件數字化翻轉處理形成即要再造耳廓的相片,然後進行耳廓軟骨支架的彫刻,用擴張後的患耳乳突區皮瓣覆蓋彫刻的自體肋軟骨耳廓支架行耳廓再造。結果1102例(1165耳)經過6箇月~10年的隨訪觀察。其中56例(56耳)再造耳廓有不同程度的軟骨吸收、變形;2例(2耳)肋軟骨支架感染、肋軟骨液化、壞死;1044例(1107耳)再造耳廓與健耳匹配,凹凸結構顯示清晰,形狀相似、逼真,顱耳角的角度與健耳對稱。結論用皮膚軟組織擴張法行耳廓再造,術中應用數字化技術形成患耳相片指導自體肋軟骨耳廓軟骨支架的彫刻,效果滿意、併髮癥少,是先天性小耳畸形較好的治療方法。
목적:탐토선천성소이기형적이곽재조여중건방법。방법2003년1월지2012년12월,채용피부연조직확장법,이용건이상편,통과계산궤photoshop연건수자화번전처리형성즉요재조이곽적상편,연후진행이곽연골지가적조각,용확장후적환이유돌구피판복개조각적자체륵연골이곽지가행이곽재조。결과1102례(1165이)경과6개월~10년적수방관찰。기중56례(56이)재조이곽유불동정도적연골흡수、변형;2례(2이)륵연골지가감염、륵연골액화、배사;1044례(1107이)재조이곽여건이필배,요철결구현시청석,형상상사、핍진,로이각적각도여건이대칭。결론용피부연조직확장법행이곽재조,술중응용수자화기술형성환이상편지도자체륵연골이곽연골지가적조각,효과만의、병발증소,시선천성소이기형교호적치료방법。
Objective To investigate the methods of auricle reconstruction for microtia. Methods Cases treated be-tween January 2003 and December 2012 were reviewed. Local skin was expanded and the autologous rib cartilaginous skele-ton was shaped based on the digital images of auricle frames generated with the Photoshop software using photos of the con-tralateral normal auricle. The skeleton was then wrapped in expanded local skin flap to complete reconstruction. Results Pa-tients (1,165 ears) were followed-up for six months to ten years. Cartilage frame absorption and distortion of various degrees were seen in 56 patients (56 ears)and infection in 2 patients with liquefaction and necrosis of the cartilage framework. The reconstructed ear showed good match to the contralateral ear in 1,044 cases (1,107ears), with clear structural features, com-parable contours and symmetrical skull-ear angle. Conclusions In addition to adequate local skin expansion, the use of dig-ital design technology in guiding preparation of autologous rib cartilage skeleton improves auricle reconstruction outcomes with few complication, It helps improve therapy for microtia.