Department of Plastic Surgery, Robert Ballanger Hospital, 93602 Aulnay sous Bois, France.
Department of Plastic Surgery, Robert Ballanger Hospital, 93602 Aulnay sous Bois, France; Department of Surgery, Jean Verdier/Avicenne Hospital, Paris Nord University, 93000 Bobigny, France.
J Plast Reconstr Aesthet Surg. 2014 Dec;67(12):1659-62. doi: 10.1016/j.bjps.2014.08.008. Epub 2014 Aug 14.
The Antia-Buch flap is a sophisticated one-stage procedure using two chondrocutaneous flaps to reconstruct the ear helix. Because tissue laxity is largely conferred by the inferior flap, relative to the less mobile superior flap, chondrocutaneous resection of scapha is required for closure. This results in loss of ear height and limits morphologic outcome. We describe a modification of the Antia-Buch flap, which may avoid such drawbacks.
We conducted a retrospective review of patients (n = 15), each undergoing our modified Antia-Buch flap between 2010 and 2014. All procedures were performed under local anesthesia as outpatient procedures. Data on magnitude of resections, procedure durations, related complications, and aesthetic outcomes were collected.
The mean size of resection was 25 mm (range, 20-30 mm). The modification improved the mobility of the upper chondrocutaneous flap, eliminating the need to resect the scapha. All wounds healed uneventfully, with no skin necrosis. The morphologic outcome was satisfactory or very satisfactory in all patients, preserving the shape, height, and width of the ear.
Our modification changes the upper flap from an advancement flap to a transposition flap, enhancing its mobility and preempting the resection of the scapha. Thus, anatomic landmarks, aesthetic subunits of the pinna, and ear height are maintained for highly satisfactory morphologic results.
反 Buch 皮瓣是一种复杂的一期手术，使用两个软骨皮瓣来重建耳轮。由于下皮瓣相对于活动度较小的上皮瓣提供了更多的组织松弛度，因此需要切除舟状骨来闭合皮瓣。这会导致耳轮高度的丧失，并限制形态学结果。我们描述了反 Buch 皮瓣的一种改良方法，可能避免这些缺点。
我们对 2010 年至 2014 年间接受我们改良的反 Buch 皮瓣的 15 名患者（n = 15）进行了回顾性研究。所有手术均在局部麻醉下作为门诊手术进行。收集了切除量、手术时间、相关并发症和美学结果的数据。
平均切除量为 25 毫米（范围 20-30 毫米）。改良后的方法提高了上皮软骨皮瓣的活动度，避免了切除舟状骨。所有伤口均愈合良好，无皮肤坏死。所有患者的形态学结果均为满意或非常满意，保持了耳朵的形状、高度和宽度。
我们的改良方法将上皮瓣从推进瓣改变为转位瓣，增强了其活动度，并预先避免了舟状骨的切除。因此，解剖标志、耳轮的美学亚单位和耳轮高度得以维持，获得了非常满意的形态学结果。
4 级
