中华耳科学杂志
中華耳科學雜誌
중화이과학잡지
CHINESE JOURNAL OF OTOLOGY
2013年
4期
529-532
,共4页
黄琬璐%杨庆华%蒋海越%林琳%宋宇鹏%刘戈%燕静杰
黃琬璐%楊慶華%蔣海越%林琳%宋宇鵬%劉戈%燕靜傑
황완로%양경화%장해월%림림%송우붕%류과%연정걸
烧伤性耳缺损%皮肤扩张法%自体肋软骨支架%耳再造
燒傷性耳缺損%皮膚擴張法%自體肋軟骨支架%耳再造
소상성이결손%피부확장법%자체륵연골지가%이재조
Auricular defect after burn%skin expansion%autogenous costal cartilage framework%auricular reconstruction
目的:探讨皮肤扩张法耳廓再造术在烧伤后耳廓不同程度缺损修复中的应用效果和操作要点。方法手术分两期进行:一期行耳后乳突区皮肤扩张器植入术;二期取出扩张器,形成蒂在前方的耳后皮瓣及耳后皮下组织筋膜瓣,采取自体肋软骨雕刻成耳支架,将耳支架植入耳后皮瓣与筋膜瓣之间,乳突区创面植以中厚皮片,共修复33例烧伤后耳缺损患者。结果33例患者术后皮瓣血运良好,无坏死,植皮均成活,6~12个月以后外形良好,形态逼真,立体感强,耳轮、对耳轮、三角窝均清晰可见,耳廓无明显异位或变形吸收,无明显挛缩。再造耳廓外形满意。结论皮肤扩张法耳廓再造术应用于烧伤性耳廓不同程度缺损畸形的耳廓再造,是一项切实可行的手术方法。
目的:探討皮膚擴張法耳廓再造術在燒傷後耳廓不同程度缺損脩複中的應用效果和操作要點。方法手術分兩期進行:一期行耳後乳突區皮膚擴張器植入術;二期取齣擴張器,形成蒂在前方的耳後皮瓣及耳後皮下組織觔膜瓣,採取自體肋軟骨彫刻成耳支架,將耳支架植入耳後皮瓣與觔膜瓣之間,乳突區創麵植以中厚皮片,共脩複33例燒傷後耳缺損患者。結果33例患者術後皮瓣血運良好,無壞死,植皮均成活,6~12箇月以後外形良好,形態逼真,立體感彊,耳輪、對耳輪、三角窩均清晰可見,耳廓無明顯異位或變形吸收,無明顯攣縮。再造耳廓外形滿意。結論皮膚擴張法耳廓再造術應用于燒傷性耳廓不同程度缺損畸形的耳廓再造,是一項切實可行的手術方法。
목적:탐토피부확장법이곽재조술재소상후이곽불동정도결손수복중적응용효과화조작요점。방법수술분량기진행:일기행이후유돌구피부확장기식입술;이기취출확장기,형성체재전방적이후피판급이후피하조직근막판,채취자체륵연골조각성이지가,장이지가식입이후피판여근막판지간,유돌구창면식이중후피편,공수복33례소상후이결손환자。결과33례환자술후피판혈운량호,무배사,식피균성활,6~12개월이후외형량호,형태핍진,입체감강,이륜、대이륜、삼각와균청석가견,이곽무명현이위혹변형흡수,무명현련축。재조이곽외형만의。결론피부확장법이곽재조술응용우소상성이곽불동정도결손기형적이곽재조,시일항절실가행적수술방법。
Objective To investigate the result and operating points of auricular reconstruction with skin expansion in the repairing of different degrees of auricular defects after burn. Methods The operation consists of two stages. StageΙ:A skin expander is implanted into subdermal space in the post auricular mastoid region;Stage II:Remove the skin expander, and lift a retro-auricular skin flap pedicled on the anterior side. After sculptured and assembled, autogenous costal cartilage framework is placed between the Retro-auricular skin flap and fascia flap. The wound in the mastoid region is covered with medium thickness skin graft. 33 patients with auricular defects after burn were repaired. Results All the flaps of thirty-three patients had good blood supply and no necrosis occurred in the flap and skin graft after operation. After a follow up of 6~12 months, the reconstructed auricles had good appearance, lifelike shape and strong sense of three-dimension. The helix, antihelix and triangular fossa were clear. The costal cartilage framework did not show any indication of absorption, deformation and contrac-tion. Above all, the reconstructed auricle showed satisfactory appearance. Conclusion Auricular reconstruction with skin ex-pansion is a practicable method to auricular reconstruction of the different degrees of auricular defect after burn.