摘要
目的:探讨应用耳后三瓣法修复先天性耳垂缺损的方法及效果。方法:回顾性分析2019年3月至2021年12月首都医科大学附属北京安贞医院和中国医学科学院整形外科医院收治的应用耳后三瓣法修复先天性耳垂缺损患者的临床资料,具体方法是在耳后区域设计A、B、C 3个皮瓣,A瓣面积比缺损面积大10%~20%,向前下缺损的方向转移,用于修复耳垂缺损;B瓣设计成一个旋转皮瓣,向A瓣方向旋转,用于修复A瓣移植后的继发缺损;C瓣设计成一个滑行推进皮瓣,用于减轻耳后区创面的张力。术后观察皮瓣血运情况,有无感染、血肿等并发症,以及伤口愈合后瘢痕情况。采用问卷对患方进行满意度调查,1~4分分别表示不满意、一般、满意和非常满意。结果:共纳入10例患者,男3例,女7例;年龄7~18岁,平均11岁;均为单侧耳垂缺损;术后出现感染1例,经局部消毒、口服抗生素治疗3 d后好转,局部小血肿1例,经换药后痊愈,无皮瓣坏死等并发症。随访3~6个月,无皮瓣坏死,修复后耳垂的色泽、形态、饱满度较好,耳后区域瘢痕较隐蔽。满意度调查显示,非常满意8例,满意2例。结论:采用耳后三瓣法修复先天性耳垂缺损,再造耳垂形态自然,瘢痕隐蔽,临床效果满意。
Objective To investigate the method and effect of retroauricular three flaps for repair of congenital earlobe defect.Methods From March 2019 to December 2021,the data of patients with congenital earlobe defect treated with retroauricular three-flap method in Beijing Anzhen Hospital,Capital Medical University and Plastic Surgery Hospital,Chinese Academy of Medical Sciences were retrospectively analyzed.The specific method was to design three flaps in the posterior auricular region,A,B,C respectively.The area of flap A was larger 10%-20%than the defect area,and the flap A was rotated in the direction of the anterior and inferior earlobe.The flap B was designed as a rotation flap to repair the secondary defect after flap transplantation.The flap C was designed as a sliding flap to reduce the tension of the wound in the retroauricular region.Postoperative observation included flap blood flow,complications of infection,hematoma,and so on,and scar after wound healing.A questionnaire was used to investigate the satisfaction of patients or guardians,with scores from 1 to 4 indicating dissatisfaction,general satisfaction,satisfaction,and very satisfaction respectively.Results A total of 10 patients were included,including 3 males and 7 females.Aged from 7-18 years old,with an average of 11 years old.All cases were unilateral lobe defects.Postoperative infection occurred in 1 case and small local hematoma in 1 case.All cases were cured after dressing change without flap necrosis and other complications.After 3 to 6 months of follow-up,there was no flap necrosis,the color,shape and plumpness of the repaired earlobe were good,and the scar behind the ear was concealed.The satisfaction survey showed that 8 cases had great satisfaction and 2 cases had satisfaction.Conclusion Partial or total defects of earlobe can be repaired by retroauricular three flaps.The reconstructed earlobe has natural shape,hidden scar and satisfactory clinical effect.
作者
陈长永
张玲
杨庆华
Chen Changyong;Zhang Ling;Yang Qinghua(Department of Plastic Surgery and Laser Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;The First Department of Otoplastic and Reconstructive Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China)
出处
《中华整形外科杂志》
CSCD
2023年第1期65-70,共6页
Chinese Journal of Plastic Surgery
基金
中国医学科学院整形外科医院院所基金(YS202034)。
关键词
耳外科手术
耳垂缺损
皮瓣移植
Otologic surgical procedures
Congenital earlobe defect
Skin flap transplantion
