Scaglioni Mario F, Suami Hiroo, Brandozzi Giuliano, Dusi Daniele, Chang Edward I
Department of Plastic Surgery, Ospedali Riuniti di Ancona, Univerista' Politecnica delle Marche, Ancona, Italy; Department of Plastic Surgery, the University of Texas MD Anderson Cancer Center, Houston, TX.
Microsurgery. 2015 Mar;35(3):190-5. doi: 10.1002/micr.22322. Epub 2014 Sep 8.
Reconstruction of anterior ear defects is poorly described, but using "like" tissue provides the optimal reconstruction. We present a cadaveric dissection and our experience with the pedicled superficial temporal artery perforator (STAP) flap for reconstruction of partial ear defects.
Two cadavers were dissected bilaterally (n = 4) following injection of latex and barium sulfate. A retrospective review of 20 consecutive patients undergoing reconstruction with the STAP flap from 2009 to 2012 was performed. Twenty patients underwent reconstruction of anterior ear defects following resection for non-melanoma skin malignancies using a tunneled pedicled STAP flap (scapha: 5, triangular fossa: 2, scapha and triangular fossa: 13).
Two perforators were identified in all dissections with one perforator at the level of the tragus, and the second perforator within 1 cm cephalad to the tragus. Thirteen patients underwent reconstruction following basal cell carcinoma excision and seven patients were reconstructed following excision of squamous cell carcinoma. There were no flap losses, but four flaps (20%) developed congestion at the tip of the flap that resolved without need for flap delay, leeching, or vasodilators. No patients developed complications with the donor site, and no patients underwent revisions. With a mean follow-up of 27.3 months (range: 19-38 months), all patients were pleased with their aesthetic outcomes and alive without recurrent disease.
The STAP flap is a pedicled perforator flap providing local "like" tissue that can be utilized for resurfacing of defects involving the anterior upper external ear with minimal donor site morbidity.
耳部前侧缺损的重建方法鲜有描述，但使用“类似”组织可实现最佳重建效果。我们展示了尸体解剖情况以及我们使用带蒂颞浅动脉穿支（STAP）皮瓣修复部分耳部缺损的经验。
对两具尸体双侧进行解剖（n = 4），先注入乳胶和硫酸钡。对2009年至2012年连续20例行STAP皮瓣重建手术的患者进行回顾性研究。20例患者因非黑色素瘤皮肤恶性肿瘤切除后，采用隧道式带蒂STAP皮瓣修复耳部前侧缺损（耳舟：5例，三角窝：2例，耳舟和三角窝：13例）。
所有解剖均发现两个穿支，一个穿支位于耳屏水平，另一个穿支在耳屏上方1厘米范围内。13例患者在基底细胞癌切除后进行了重建，7例患者在鳞状细胞癌切除后进行了重建。未出现皮瓣坏死，但有4例皮瓣（20%）在皮瓣尖端出现充血，无需进行皮瓣延迟、水蛭吸血或使用血管扩张剂即可缓解。供区未出现并发症，也没有患者进行修复手术。平均随访27.3个月（范围：19 - 38个月），所有患者对美学效果满意，且无疾病复发存活。
STAP皮瓣是一种带蒂穿支皮瓣，可提供局部“类似”组织，用于修复涉及耳部前上外侧的缺损，供区并发症最少。
