Department of Ear, Nose, and Throat Diseases, Head and Neck Surgery, Ulm University Hospital, Ulm, Germany.
Am J Rhinol Allergy. 2013 Mar-Apr;27(2):e53-7. doi: 10.2500/ajra.2013.27.3883.
Autologous transplants consisting of skin and cartilage, so-called composite grafts (CGs), are useful in nasal reconstruction of multilayered defects. A CG from the auricle's cavum conchae serves both functional and esthetic demands. This article outlines the indications and the requirements of the CG, making special considerations to improve wound healing, and discusses our results in consideration with recent publications.
A retrospective case-control study assessing the functional and esthetic long-term results in the donor and recipient site is presented.
Between 2005 and 2011, 91 patients received differently sized CGs of the auricle for nasal reconstruction. In 85/91 cases the donor site defect was closed using a retroauricular pedicled island flap. Six of 91 defects were closed primarily. Indications were multilayered defects of the nasal vestibule, the nasal floor, the inner nasal valve, and the lateral sidewall. The main indication for surgery was skin malignancies. One of 91 major and 14/91 minor complications were observed. Seventy-seven of 91 patients received a custom-made prosthesis to prevent stenotic scarring. The 2.5-year follow-up showed excellent results of stability and shape at the donor and recipient site.
The auricular inner lining CG is a versatile and reliable autologous transplant, which is ideal for multilayered nasal reconstruction because of easy harvesting, little donor site morbidity, and its convex shape. Septal splints and custom-made prosthesis secure healing and prevent stenotic scarring.
由皮肤和软骨组成的自体移植物，即所谓的复合移植物（CG），在多层缺陷的鼻重建中非常有用。来自耳甲腔的 CG 既满足功能需求，又满足美学需求。本文概述了 CG 的适应证和要求，并特别考虑了改善伤口愈合的问题，并结合最近的出版物讨论了我们的结果。
回顾性病例对照研究评估了供体和受区的功能和美学长期结果。
2005 年至 2011 年间，91 例患者因鼻重建接受了不同大小的耳 CG。在 91 例中有 85 例采用耳后带蒂岛状皮瓣关闭供区缺损。6 例直接一期缝合。适应证为鼻前庭、鼻底、内鼻阀和外侧壁的多层缺陷。手术的主要指征是皮肤恶性肿瘤。观察到 91 例中的 1 例严重并发症和 14 例轻微并发症。91 例中有 77 例接受了定制假体以防止狭窄性瘢痕形成。2.5 年随访显示供区和受区的稳定性和形状均极佳。
耳内 CG 是一种多功能且可靠的自体移植物，非常适合多层鼻重建，因为其易于采集、供区并发症少，且形状呈凸形。鼻中隔夹板和定制假体可确保愈合并防止狭窄性瘢痕形成。
