【作者】 史吏；

【导师】 李光早；

【作者基本信息】 蚌埠医学院 ， 临床医学， 2012， 硕士

【摘要】 目的：讨论应用皮肤扩张法耳郭再造术治疗先天性小耳畸的手术方法，总结其优势及不足。方法：根据我科2008年12月-2011年12月16例采用皮肤扩张法耳郭再造术治疗的小耳畸形综合症患者，讨论皮肤扩张法耳郭再造术的手术方法。手术主要为两期，即一期扩张器置入，二期取自体肋软骨雕刻成耳支架，用耳后筋膜瓣和耳后扩张皮瓣覆盖支架。后可依术后具体情况按照患者需要选择性行三期耳屏再造，耳甲腔加深及修整局部形态等手术。结果：16例患者均手术顺利，术后再造耳形态良好，患者满意。2例患者一期手术后出现血肿，未发生感染或扩张器外露。1例扩张器植入术后出现注射壶处慢性渗液，经二期肋软骨雕刻耳再造手术后再造耳形态良好。1例出现皮瓣远端表皮坏死，结痂脱落后自行痊愈,无软骨外露，未影响再造耳外形。随访6—12个月，再造耳形态良好，耳颅角成形佳，移植的软骨支架未出现吸收、软化、变形，再造耳位置、大小，形态均与健侧相似。结论：扩张器法耳郭再造术成功率高，术后再造耳形态逼真，是治疗先天性小耳畸形理想的手术方式。更多还原

【Abstract】 Objective: Discussion the operative techniques of auricle reconstruction using soft tissueskin expander，and summarize their advantages and disadvantages.Method: A total of16cases of auricle reconstruction using soft tissue skin expander wasperformed from December2009to December2011.Discussion the auriclere constructionsurgery using soft tissue skin expander according to the clinical data.The surgery havetwo stages,the one-stage operation is implanting soft tissue skin expander，the two-stageoperation is carveing autogenous rib cartilage framework and covering with fascial flapand expanded flap.Then tragus reconstruction,cavity of concha deepen operation, andlocal shape trimming operation can be performed according to requirement of patients.Result:The16patients of microtia were treated successfully.Two cases occurredhematoma after the one-stage operation.One case occurred chronic effusion at theinjection pot,but the reconstructed ear was in good shape after auricle reconstruction. Inother one case,the distal part of the flap was necrotic,then had healed after scabs felloff.After6-12months following up, the reconstructed ears were all in good shapewithout distortion and cartilage resorption, the locations, sizes and appearances ofreconstructed ears were similar to uninjured sides.Conclusion: The auricle reconstruction using soft tissue skin expander have a highsuccess rate,the shape of reconstructed ear are lifelike.At present time, it was a goodmethod to use soft tissue skin expander in auricle reconstruction.更多还原