“全扩张法”耳廓再造术的临床应用及适应症的探讨

发布时间：2018-03-31 21:18

本文选题：先天性小耳畸形　切入点：耳廓再造术　出处：《中华耳科学杂志》2017年03期

【摘要】：目的分析与总结"全扩张法"耳廓再造术治疗先天性小耳畸形的临床经验,并探讨该方法的适应症。方法自2014年7月至2016年6月,根据患者年龄、耳后乳突区皮肤厚度及松紧度差异,选择年龄大于8岁、耳后皮肤松弛的患者共220例采用"全扩张法"耳郭再造术。手术分三期完成,一期耳后扩张器置入术,二期全耳再造术,三期再造耳修整术。结果 220例患者术后平均随访9个月,196例(89.0%)患者及家属对再造耳廓形态满意,21例(9.5%)认为再造耳廓可以接受,3例(1.4%)对再造耳形态不满意。216例(98.2%)患者胸部瘢痕均未超过4cm,最短只有1.5cm,未出现明显的胸廓畸形;扩张期相关并发症发生率3.2%,再造耳并发症发生率5.0%。结论"全扩张法"耳廓再造术是治疗先天性小耳畸形的理想术式之一。患者年龄大于8岁、耳后乳突区皮肤松弛,是"全扩张法"耳廓再造术治疗先天性小耳畸形的适应症。
[Abstract]:Objective to analyze and summarize the clinical experience of "total dilation" auricle reconstruction in the treatment of congenital microauricle malformation, and to explore the indication of this method. Methods from July 2014 to June 2016, according to the age of the patients, The thickness and tightness of the skin in the posterior mastoid area were different. 220 cases of patients aged over 8 years with skin relaxation behind the ear were treated with "total dilatation" auricle reconstruction. The operation was completed in three stages, and one stage retroauricular dilator implantation was performed. Second stage total ear reconstruction, Results 220 patients were followed up for an average of 9 months (196 / 89. 0) the patients and their family members were satisfied with the shape of reconstructed auricle in 21 cases (9.5%). It was considered that the reconstructed auricle could be accepted in 3 cases (1.4%). 216 cases (98.22%) were not satisfied with the reconstructed ear shape. The chest scar was not more than 4 cm and the shortest was only 1.5 cm. There was no obvious thoracic deformity. The incidence of complications in dilation period was 3.2 and that of reconstructed ear was 5.0.Conclusion Total expansion method is one of the ideal methods for the treatment of congenital microauricular malformation. The patient is more than 8 years old, and the skin of the posterior mastoid region is loose. It is the indication of auricle reconstruction in the treatment of congenital microauricle malformation.
【作者单位】：北京大学国际医院整形外科;中国医学科学院整形外科医院耳再造二中心;
【基金】：国家自然科学基金面上项目(81571924)~~
【分类号】：R764.9

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