耳后皮肤充分扩张行小耳畸形耳再造临床分析

发布时间：2018-03-25 16:38

本文选题：小耳畸形　切入点：扩张术　出处：《昆明医科大学》2017年硕士论文

【摘要】：[目的]探讨耳后皮肤充分扩张法施行耳再造的可行性和临床效果。[方法]采用耳后皮肤扩张法对2015年1月至2017年3月间55例先天性小耳畸形患者实施手术治疗。手术共分为三期进行,第一期手术:在耳后皮肤埋置50-80ml扩张器,术后一周开始注水扩张,每周注水1-2次,每次3-5ml,扩张时间为3-4个月,注水总量为90-110ml;第二期手术:选用自体骨制作支架,切取对侧胸部第6,7,8或6,7肋软骨制作三维耳支架,用扩张好的耳后皮瓣包裹,持续负压吸引耳廓成型;第三期手术:进行耳垂转位,加深外耳道,完成耳廓再造。[结果]从2015年1月至2017年3月用耳后皮肤扩张法完成小耳畸形耳廓再55例,随访6个月-2年,5例出现扩张器外露、感染及耳软骨外露效果不佳外,50例效果满意,再造的耳廓位置、大小、角度、外形与对侧耳廓基本对称。[结论]耳后皮肤充分扩张耳再造的方法,能提供包裹耳支架所需要的皮肤,耳后不用再植皮,可达到简化手术的目的,术后再造耳廓色泽形态自然,能获得很好的效果。
[Abstract]:[objective] to investigate the feasibility and clinical effect of the method of full expansion of retroauricular skin for ear reconstruction. [methods] 55 cases of congenital microauricular malformation from January 2015 to March 2017 were treated with retroauricular skin dilatation. The operation was divided into three phases, The first stage operation: the 50-80ml expander was implanted in the skin behind the ear, and the water injection was started one week after the operation. The first stage was 3 to 5 ml per week, the time of expansion was 3-4 months, the total water injection was 90-110 ml; the second stage operation: autogenous bone was used to make the stent. The third stage of operation was performed by transposition of the ear lobe to deepen the external auditory canal, and the third stage of operation was to make three-dimensional auricular scaffold by cutting the 6 ~ (7) or 6 ~ (7) costal cartilage of the contralateral chest, and wrap it with an expanded posterior ear flap to attract the auricle into shape continuously under negative pressure. [results] from January 2015 to March 2017, 55 cases of auricle deformity were performed with retroauricular skin dilatation, and 5 cases were followed up for 6 months to 2 years. The position, size, angle and shape of the reconstructed auricle are basically symmetrical with those of the contralateral auricle. [conclusion] the method of fully expanding and reconstructing the auricle behind the ear can provide the skin needed to wrap the scaffold of the ear, without the need of the skin graft behind the ear. It can simplify the operation, and can obtain good results.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R764.9

【参考文献】