中国美容医学2017，Vol.26Issue(8)：31-34,4.
人工骨与耳后筋膜在Nagata法耳廓再造颅耳角成形术中的应用
Application of Artificial Bone and Retroauricular Fascial Flap in Elevation of the Auricle Reconstructed with Nagata Method
郑胜武 1黄雄梅 1庄兢 1郑清健1
作者信息
- 1. 福建医科大学省立临床医学院福建省立医院整形外科 福建 福州 350001
- 折叠
摘要
Abstract
Objective To investigate the application of artificial bone and retroauricular fascial flap in elevation of the auricle which is reconstructed with Nagata method. Methods From June 2010 to June 2015, total auricle reconstruction was performed in 42 patients with congenital microtia. The first stage operation was performed according to the Nagata's method, which involved obtaining contralateral 6, 7 and 8 costal cartilages to fabricate auricle framework and implantation of the costal cartilage framework. The second stage operation was the reconstructed auricle elevation, which was performed 6 months later. Skin incision was made 5mm outside of the posterior margin of the auricle, dissection was performed just beneath the framework and above the fascial plane. The reconstructed auricle framework was separated from the under lying bed. A curved artificial bone was implanted to the posterior wall of the concha to get the same cephaloauricular angle as the contralateral ear, the cephaloauricular angle of the bilateral microtia was designed 30-45 degrees. The retroauricular fascial flap was harvested to wrap the artificial bone and the reconstructed auricle framework. Then, the split-thickness scalp skin was harvested and grafted on the fascia surface. The skin graft was fixed with a tie-over compression dressing of wet gauze. Results After the second stage operation, epidermis blisters were found in 4 cases, which healed well after extracting bubble liquid and changing dressing regularly. Partial retroauricular fascial flap necrosis occurred in 1 case which lead to auricle framework exposure. It was repaired by superficial temporal fascia flap and skin graft. The patients were followed up for 6-24 months, with an average of 15 months. The cephaloauricular angles of the 39 patients were satisfactory. 3 patients had serious skin and scar contracture, which affected the angle and shape of the cephaloauricular angle. Conclusion The application of artificial bone and retroauricular fascial flap in elevation of the reconstructed auricle can provide satisfactory cephaloauricular angle structure, and avoids excessive resection of costal cartilage and excessive thorax trauma.关键词
先天性小耳畸形/耳廓再造术/颅耳角成形术/人工骨/耳后筋膜瓣Key words
congenital microtia/auricle reconstruction/auricle elevation/artificial bone/retroauricular fascial flap分类
医药卫生引用本文复制引用
郑胜武,黄雄梅,庄兢,郑清健..人工骨与耳后筋膜在Nagata法耳廓再造颅耳角成形术中的应用[J].中国美容医学,2017,26(8):31-34,4.
