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[应用耳后扩张皮瓣及Medpor支架行外耳再造的临床研究]

[Clinical study on external ear reconstruction using expanded postauricular flap and medpor framework].

作者信息

Song Chunqiong, Jiao Feng, Zhuang Hongxing

机构信息

External Ear Plastic Center, Plastic Surgery Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2007 Jan;21(1):40-3.

Abstract

OBJECTIVE

To explore the feasibility of applying porous high density polyethylene (Medpor) as framework for auricle reconstruction of congenital or acquired auricular defects.

METHODS

From February 1999 to February 2004, 61 patients suffering from congenital or acquired auricular defects underwent auricle reconstruction with Medpor framework after expanding postauricular skin. Among them, there were 38 males and 23 females, aging from 5 to 61 years. In 40 cases of congenital microtia, two sides were involved in 1 case and one side in 39 cases. In 21 cases of traumatic auricle damage, two sides were involved in 6 cases and one side in 15 cases. The operation was performed by two stages. First stage: the expander was implanted underneath postauricular skin or soft tissue such as notrophic scar tissue for the traumatic auricle defect. Second stage:the expander was removed and auricle reconstruction was performed by placing Medpor framework between the expanded skin/scar flap and the underlying fascial flap.

RESULTS

Sixty-one patients obtained successfully reconstructed auricles. During a follow-up of 6 months to 5 years and 1 month (mean 2.8 years), the results were excellent and good in 49 cases (80.3%), fair in 7 cases (11.5%) and poor in 3 cases (4.9%), 2 cases (3.3%) underwent replacement of Medpor framework with autogenous costal cartilage after 6 months of operation.

CONCLUSION

Medpor framework would be applied safely, simply and reliably in condition that auricular framework is unfit or reluctant to undergo auricle reconstruction by using autogenous costal cartilage.

摘要

目的

探讨应用多孔高密度聚乙烯(Medpor)作为先天性或后天性耳廓缺损耳廓再造支架的可行性。

方法

1999年2月至2004年2月,61例先天性或后天性耳廓缺损患者在耳后皮肤扩张后采用Medpor支架进行耳廓再造。其中男38例,女23例,年龄5~61岁。先天性小耳畸形40例,双侧1例,单侧39例。外伤性耳廓缺损21例,双侧6例,单侧15例。手术分两期进行。一期:对于外伤性耳廓缺损,将扩张器植入耳后皮肤或软组织如萎缩性瘢痕组织下方。二期:取出扩张器,将Medpor支架置于扩张后的皮肤/瘢痕瓣与下方筋膜瓣之间进行耳廓再造。

结果

61例患者耳廓再造均获成功。随访6个月至5年1个月(平均2.8年),优49例(80.3%),良7例(11.5%),可3例(4.9%),差2例(3.3%),其中2例术后6个月采用自体肋软骨置换Medpor支架。

结论

在耳廓支架不宜或不愿采用自体肋软骨进行耳廓再造的情况下,Medpor支架应用安全、简便、可靠。

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