Harbison John M, Kriet J David, Humphrey Clinton D
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
Curr Opin Otolaryngol Head Neck Surg. 2012 Aug;20(4):267-73. doi: 10.1097/MOO.0b013e328355b1f2.
Auricular composite grafting is a useful technique for the reconstruction of select nasal defects. However, unpredictable graft survival has been the primary limitation of this technique. The literature was reviewed to evaluate the effectiveness of various surgical, pharmacologic, hyperbaric, and hypothermic interventions to improve composite graft survival.
Although no statistically significant surgical interventions were found, several techniques appear promising. There are a number of studies demonstrating the beneficial effects of perioperative and postoperative corticosteroid administration. Other agents studied have had modest to no benefit. Hyperbaric oxygen therapy holds promise but the expense, practicality, and lack of an established optimal treatment protocol remain obstacles to routine use.
The use of corticosteroids and postoperative cooling are relatively inexpensive and effective modalities to improve auricular composite graft survival when used for nasal reconstruction. Hyperbaric oxygen therapy may have a role, but more research is needed before it is employed routinely.
耳廓复合组织移植是修复特定鼻缺损的一种有用技术。然而，移植成活率不可预测一直是该技术的主要局限性。本文回顾了相关文献，以评估各种手术、药物、高压氧和低温干预措施对提高复合组织移植成活率的有效性。
虽然未发现具有统计学意义的手术干预措施，但有几种技术似乎很有前景。多项研究表明围手术期和术后使用皮质类固醇有有益效果。其他研究的药物效果甚微或没有益处。高压氧治疗有前景，但费用、实用性以及缺乏既定的最佳治疗方案仍是常规使用的障碍。
当用于鼻再造时，使用皮质类固醇和术后降温是提高耳廓复合组织移植成活率相对廉价且有效的方法。高压氧治疗可能有作用，但在常规应用之前还需要更多研究。
