Olbricht Suzanne, Liégeois Nanette J
Department of Dermatology, Harvard Medical School, Boston, MA, USA.
Semin Cutan Med Surg. 2003 Dec;22(4):273-80. doi: 10.1016/S1085-5629(03)00077-4.
Closing surgical defects of the external ear poses unique challenges because of the convoluted shape and thin tethered skin. Choice of repair is often dictated by the site of the wound. If the defect is central and anterior with intact cartilage, most defects will do well by second intention healing or grafting. If the defect involves the helical rim, reconstruction is often preferred to maintain the normal curvature of the external ear and a helical rim advancement flap with trimming of the central cartilage is often used. Defects of the posterior ear where the skin is more abundant and loose can often be closed side to side. Split earlobes may be repaired by Z-plasty. The full range of repair options should be considered in every case. Because each ear differs in shape and flexibility, creativity is warranted, rewarding both the patient and the surgeon.
由于外耳形状复杂且皮肤薄而相连，闭合外耳手术缺损带来了独特的挑战。修复方法的选择通常取决于伤口的位置。如果缺损位于中央且靠前，软骨完整，大多数缺损通过二期愈合或移植效果良好。如果缺损累及耳轮边缘，通常更倾向于进行重建以保持外耳的正常曲率，并且经常使用带有中央软骨修整的耳轮推进皮瓣。耳后皮肤更丰富且松弛的缺损通常可以直接缝合。耳垂裂开可以通过Z成形术修复。每种情况都应考虑全面的修复选择。由于每只耳朵的形状和柔韧性都不同，需要发挥创造力，这对患者和外科医生都有益。
