Lassus Patrik, Husso Annastiina, Vuola Jyrki, Lindford Andrew J
Department of Plastic Surgery, Töölö Hospital, Helsinki University Hospital, University of Helsinki, Finland.
Microsurgery. 2018 Sep;38(6):611-620. doi: 10.1002/micr.30178. Epub 2017 Apr 1.
We herein present our experience using free flaps harvested from the ear region in facial, nasal and intraoral reconstruction.
Between 2011 and 2016, 19 patients underwent reconstruction using 20 free flaps from the ear region based on the superficial temporal vessels. There were 10 males and 9 females with a mean age of 57 years. Defect aetiology consisted of post-tumour ablation (n = 15), trauma (n = 2) and burn scar (n = 2). Defect location involved the nose (n = 13), floor of mouth (n = 3), tongue (n = 1), lower eyelid (n = 1), and lower lip (n = 1).
Twelve helical, seven temporal artery posterior auricular skin (TAPAS), and one hemiauricular flap were performed. One patient required venous re-anastomosis but complete flap necrosis eventually occurred. This patient later underwent successful contralateral helix flap reconstruction. Overall flap survival was 95%. Follow-up ranged from 12 to 69 months. A moderate to excellent aesthetic and functional outcome was achieved in all cases, but most (13/19) required later minor refinement surgery.
As a versatile source of free flap options, the ear can provide more than just the helix.
本文介绍我们使用耳部区域切取的游离皮瓣进行面部、鼻部和口腔内重建的经验。
2011年至2016年间，19例患者采用基于颞浅血管的20个耳部区域游离皮瓣进行重建。其中男性10例，女性9例，平均年龄57岁。缺损病因包括肿瘤切除术后（n = 15）、创伤（n = 2）和烧伤瘢痕（n = 2）。缺损部位包括鼻子（n = 13）、口底（n = 3）、舌（n = 1）、下眼睑（n = 1）和下唇（n = 1）。
共进行了12例耳轮皮瓣、7例颞浅动脉耳后皮肤（TAPAS）皮瓣和1例半耳皮瓣手术。1例患者需要进行静脉重新吻合，但最终皮瓣完全坏死。该患者后来成功接受了对侧耳轮皮瓣重建。总体皮瓣存活率为95%。随访时间为12至69个月。所有病例均取得了中度至良好的美学和功能效果，但大多数（13/19）患者后期需要进行小型精细手术。
作为游离皮瓣选择的多功能来源，耳部不仅可以提供耳轮组织。
