目的:探索改善先天性小耳畸形患者皮肤扩张法耳廓再造效果的方法及其常见并发症的防治。方法回顾性分析解放军总医院耳鼻咽喉头颈外科2006.7-2012.12由笔者完成的204例(245耳)采用耳后皮肤扩张法完成的耳廓再造患者资料,根据再造耳廓的逼真性及双侧对称性进行Ⅰ-Ⅳ级效果评定。结果Ⅰ、Ⅱ、Ⅲ、Ⅳ级比例分别为54.7%(134/245)、42.0%(103/245)、2.9%(7/245)、0.4%(1/245)。感染、耳廓支架外露、切口裂开各2例,耳后血肿、皮下瓣部分无菌性坏死各1例,经过及时恰当处理后均顺利愈合。结论耳后皮肤扩张法耳廓再造术是先天性小耳畸形患解决外观问题的良好方法,及时正确的处理可以预防各种并发症的产生或消除其产生后的影响。
Objective To explore the method to improve effect of auricle reconstruction by skin expanding for congeni?tal microtia and prevent/treat its common complications. Methods a retrospective analysis of 204 cases (245 ears) undergone the auricle reconstruction by skin expanding method in department of Otolaryngology Head and neck surgery , General Hospi?tal of PLA during 2006.7-2012.12, and the effect is evaluated as levelⅠ-Ⅳaccording to the verisimilitude and bilateral symmetry. ResultsⅠ,Ⅱ,Ⅲ,Ⅳgrade rates were 54.7%(134/245), 42%(103/245), 2.9%(7/245), 0.4%(1/245) respective?ly, 2 cases each for Infection , auricle framework exposure and wound disruption. hematoma and part aseptic necrosis of the subcutaneous flap each 1 case, all were healed smoothly after appropriate and timely treatment. Conclusion It is a good method to solve appearance problem for congenital microtia patient by auricle reconstruction with skin expanding, and compli?cations can be prevented or eliminated the influence after timely and correct treatment.