CAJ | 학술논문

目的探讨成人小耳畸形的扩张器法耳廓再造术的序贯治疗.方法第一期手术行皮肤定量扩张器埋置;第二期扩张皮肤形成耳前扩张皮瓣(A瓣)、耳下扩张皮瓣(B瓣),同时残耳形成残耳皮瓣(C瓣),应用第七、第八或仅第七肋软骨雕刻立体支架进行耳廓再造术,A,B和C“三瓣”从前方、下后方和下方包裹支架,使用耳后筋膜瓣从后方包裹支架,筋膜瓣后方行皮片移植治疗.结果2010年1月至2012年6月,共应用成人“三瓣”技术实施扩张器法耳廓再造73例(78耳).再造耳廓立体感强、表面结构清晰可见,耳后瘢痕隐藏于颅耳沟中部.结论成人“三瓣法”小耳畸形的扩张器耳廓再造术并发症较少,再造耳廓不仅形态逼真而且耳后瘢痕隐蔽,值得推广应用.
목적탐토성인소이기형적확장기법이곽재조술적서관치료.방법제일기수술행피부정량확장기매치;제이기확장피부형성이전확장피판(A판)、이하확장피판(B판),동시잔이형성잔이피판(C판),응용제칠、제팔혹부제칠륵연골조각입체지가진행이곽재조술,A,B화C“삼판”종전방、하후방화하방포과지가,사용이후근막판종후방포과지가,근막판후방행피편이식치료.결과2010년1월지2012년6월,공응용성인“삼판”기술실시확장기법이곽재조73례(78이).재조이곽입체감강、표면결구청석가견,이후반흔은장우로이구중부.결론성인“삼판법”소이기형적확장기이곽재조술병발증교소,재조이곽불부형태핍진이차이후반흔은폐,치득추엄응용.
Objective To report a staged auricle reconstruction treatment using tissue expander in adult patients with microtia. Methods The first stage involved placement of a quantitative tissue expander over the mastoid area. In the second stage, a preauricular skin flap (A-flap) , a subauricular skin flap(B-flap) and a remnant ear flap (C-flap) were designed. The seventh (and the eighth in some cases) rib cartilage was harvested to build the auricular framework, which was then en?veloped with the A-flap from the anterior aspect, B-flap from the posterior-inferior aspect, and C-flap from the inferior as?pect. A postauricular fascial flap was also used to envelope the framework from the posterior aspect, covered with a split thickness skin graft. Results From January 2010 to June 2012, 73 adult patients with microtia (78 ears) were treated with this technique. The expanded skin flap allowed presentation of fine structures of the reconstructed auricle. The postauricu?lar scar was concealed well in the middle part of the cranioauricular sulcus. Conclusions Complications of adult auricle re?construction with this“three-flap”technique are rare. The reconstructed auricle using this technique demonstrates im?proved esthetic effects, with well hidden postauricular scar.