Wang Yanmei, Zhuang Xinghong, Jiang Haiyue, Yang Qinhua, Zhao Yanyong, Han Juan, Yu Dashan, Zhang Zhiyuan
Auricular Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Ba Da Chu Road, Shi Gin Shan District, Beijing, 100041, China.
J Plast Reconstr Aesthet Surg. 2008;61 Suppl 1:S70-6. doi: 10.1016/j.bjps.2008.07.008. Epub 2008 Sep 30.
The various layers of the scalp are widely used in reconstructive procedures. The technique used for soft tissue coverage seems to influence the framework extrusion rate in auricular reconstruction. We have investigated the role of the postauricular fascial flap in providing ample, thin neurovascular cover to facilitate ear reconstruction in congenital microtia.
Following postauricular cutaneous tissue expansion, the postauricular neurovascular fascia flap was raised to partially cover the projected three-dimensional autogenous cartilage framework. A suction drain was placed in the pocket to allow the skin to coapt to the framework and a split-thickness skin graft was applied to complete coverage.
At final assessment, the aesthetic results were analysed subjectively. Four hundred and thirty-eight ears underwent total ear reconstruction in 428 patients using the postauricular fascial flap technique. None of the reconstructions failed, and all patients were satisfied with the results.
The use of a postauricular fascial flap and skin graft enhances safety and provides better vascularisation of the underlying cartilage.
头皮的各层在重建手术中被广泛应用。用于软组织覆盖的技术似乎会影响耳廓重建中支架的外露率。我们研究了耳后筋膜瓣在为先天性小耳畸形的耳部重建提供充足、薄的神经血管覆盖方面的作用。
在耳后皮肤组织扩张后，掀起耳后神经血管筋膜瓣以部分覆盖预计的三维自体软骨支架。在腔隙内放置引流管以使皮肤与支架贴合，然后应用中厚皮片完成覆盖。
在最终评估时，对美学效果进行主观分析。428例患者的438只耳朵采用耳后筋膜瓣技术进行了全耳重建。所有重建均未失败，所有患者对结果都很满意。
使用耳后筋膜瓣和皮片可提高安全性，并为下方的软骨提供更好的血管化。
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