The Department of Plastic and Reconstruction, Union Hospital, Tongji Medical College, Huazhong Science & Technique University, No. 1277, Jiefang Dadao Road, Wuhan, China.
J Plast Reconstr Aesthet Surg. 2011 Oct;64(10):1312-7. doi: 10.1016/j.bjps.2011.05.006. Epub 2011 Jun 24.
Successful ear reconstruction depends on two factors: an ear framework and the skin covering the framework. However, the relative deficiency of skin for coverage of the cartilage framework remains an issue. This new method for total auricular reconstruction is a three-stage operation and involves the use of two tissue expanders. First, two skin expanders are implanted, one underneath the scalp and the other sited behind the microtic ear. At the second stage, after lobule transposition, the two expanded skin flaps (upper and lower) and mastoid fascial flap are raised. At the same time, the autogenous rib cartilage is harvested and the framework constructed. The cartilage framework is then anchored between the upper expanded skin flap and the fascial flap with its inferior pole inserted into the rotated earlobe. The upper expanded skin flap covers the whole anterior surface of the framework and drapes over the margins of the fascial flap, which wrap the framework from beneath. The raw surface of fascial flap is covered with the lower expanded skin flap. The formation of a pseudomeatus and tragus is performed at the third stage. Deficiency of skin is the major problem encountered with the other conventional methods. Our innovations using two tissue expanders in combination with an autogenous rib cartilage framework eliminate this problem completely.
耳架和覆盖耳架的皮肤。然而，软骨架的皮肤覆盖相对不足仍然是一个问题。这种新的全耳再造方法是一个三阶段的手术，涉及使用两个组织扩张器。首先，植入两个皮肤扩张器，一个在头皮下，另一个在小耳后。在第二阶段，完成耳垂转位后，抬起两个扩张的皮瓣（上部和下部）和乳突筋膜瓣。同时，采集自体肋软骨并构建框架。然后，将软骨框架用其下极插入旋转的耳垂之间，用上部扩张的皮瓣和筋膜瓣固定在中间。上部扩张的皮瓣覆盖整个框架的前表面，并覆盖筋膜瓣的边缘，筋膜瓣从下方包裹框架。筋膜瓣的原始表面用下部扩张的皮瓣覆盖。在第三阶段进行假耳道和耳轮的形成。其他传统方法遇到的主要问题是皮肤不足。我们使用两个组织扩张器和自体肋软骨框架的创新完全解决了这个问题。
