Meng Q Z
Plastic Surgery Hospital of Shanxi Province.
Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1992 Mar;8(1):46-8, 86-7.
Auricle is liable to be injured, owing to its position and structural conditions. Since 1977, 48 cases (52 ears) with traumatic auricular defect have been reconstructed by the use of different operative techniques. The results have been satisfactory for most of them. Loss of a major portion of the auricle or the entire ear itself can be reconstructed by use of framework of costal cartilage graft (autologous or homologous). The joint between remaining auricle and framework must be smooth and secure. Helical defect can be repaired by the use of advancement of auricular skin and cartilage, composite graft, free skin graft with subdermal vascular plexus or tube flap according to specific conditions. Unnecessary injury to tissue should be avoided during the operation. Earlobe defect can be repaired by the use of double subcutaneous pedicle skin flaps. The retroauricular subcutaneous pedicle composite flap including conchal cartilage and the pretragus subcutaneous skin flap are formed. They pass through respective subcutaneous tunnels to reach the defect area. The two flaps and remained auricular fresh edge are sutured together. A flat, new earlobe is reconstructed. The earlobe reconstructed by the use of this technique overcomes the unsightly "spherical earlobe". This technique is an ideal operative method. In brief, there are many forms of traumatic auricular defects. According to the size and extent of defect, careful planning is essential before the actual surgery takes place.
耳廓因其位置和结构特点容易受伤。自1977年以来,我们采用不同的手术方法对48例(52耳)外伤性耳廓缺损进行了再造,多数效果满意。耳廓大部分或全耳缺失可采用肋软骨支架移植(自体或异体)进行再造,残留耳廓与支架的衔接必须平整牢固。耳廓螺旋部缺损可根据具体情况采用耳廓皮肤软骨推进、复合组织移植、含真皮下血管网的游离皮片或皮管皮瓣修复。手术中应避免不必要的组织损伤。耳垂缺损可采用双皮下蒂皮瓣修复。形成耳后皮下蒂复合瓣(含耳甲软骨)及耳屏前皮下皮瓣,经各自皮下隧道至缺损区,将两皮瓣与残留耳廓创缘缝合,再造出平整的新耳垂,克服了“球形耳垂”的不雅观。该技术是一种理想的手术方法。总之,外伤性耳廓缺损有多种形态,应根据缺损大小和范围,术前精心设计。