Song Yupeng, Zhuang Hongxing, Jiang Haiyue, Yang Qinghua
Department of Auricular Reconstruction, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100144, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 Oct;24(10):1204-7.
To investigate the clinical outcome of a surgical strategy by soft tissue expansion in treating acquired auricular defect.
Between January 2007 and December 2009, 136 patients with acquired auricular defect were treated with a surgical strategy by putting autoallergic costal framework after soft tissue expansion. There were 93 males and 43 females, aged 8-60 years (median, 20 years). Defects were caused by burn in 82 cases, by trauma in 47 cases, and by bite in 7 cases. Defect involved in almost the whole auricle and earlobe in 50 patients, 2/3 superior part of auricle in 35 patients, 1/3 superior part of auricle in 31 patients, 1/3 middle part of auricle in 9 patients, and 1/3 inferior part of auricle and earlobe in 11 patients.
All the flaps had good blood supply, skin grafts all survived, and all the wounds healed by first intention after operation. All patients were followed up 6-24 months with an average of 14 months. All reconstructive auricle survived with good color, soft texture, and normal sensory function; the appearance had no enlargement and attrition, and the grafted costal cartilage framework had no melanosis, absorption, and deformation. The reconstructed ear had the same position, size, shape, and oto-cranium angle as normal ear. The curative effect was good according to ZHUANG Hongxing's evaluation standard of auricular reconstruction.
To reconstruct auricle by soft tissue expansion is an effective method. The position of putting expander and the number of expanders are different in different patients.
探讨软组织扩张术治疗后天性耳廓缺损的手术策略及临床效果。
2007年1月至2009年12月，对136例后天性耳廓缺损患者采用软组织扩张后自体肋软骨支架植入的手术方法进行治疗。其中男性93例，女性43例，年龄8～60岁（中位数20岁）。缺损原因：烧伤82例，外伤47例，咬伤7例。缺损范围：累及耳廓及耳垂大部50例，耳廓上2/3部35例，耳廓上1/3部31例，耳廓中1/3部9例，耳廓下1/3及耳垂部11例。
所有皮瓣血运良好，植皮全部成活，术后伤口均一期愈合。所有患者随访6～24个月，平均14个月。再造耳廓全部成活，颜色、质地良好，感觉功能正常；外观无增大及磨损，植入的肋软骨支架无黑素沉着、吸收及变形。再造耳与正常耳的位置、大小、形态及耳颅角相同。按庄洪兴耳廓再造评价标准，效果良好。
软组织扩张法耳廓再造是一种有效的方法。不同患者扩张器的置入位置和个数不同。
