Dyson Mary E, Orangi Maideh, Goldberg Leonard H, Kimyai-Asadi Arash
DermSurgery Associates, Houston, Texas.
Department of Medicine, Houston Methodist Hospital, Houston, Texas.
Dermatol Surg. 2019 Oct;45(10):1222-1227. doi: 10.1097/DSS.0000000000001799.
Surgical reconstruction of the anterior surface of the ear (concha, antihelix, scapha, and triangular fossa) is complicated by the paucity of mobile local skin.
This is a retrospective study of the transcartilage island pedicle flap for reconstruction of surgical defects of the anterior ear.
Two hundred thirty-two Mohs micrographic surgery defects were included in the study. The technique involves circumferential incision of the flap in the postauricular sulcus, transfer of the flap to the anterior ear through a surgically created cartilage slit, suturing of the flap on the anterior surface of the ear, and repair of the secondary postauricular defect. Preoperative, intraoperative, and postoperative details of each case were tabulated and analyzed.
The mean defect size was 1.9 × 1.5 cm. Complications included flap edema (n = 6, 2.6%), postoperative bleeding (n = 4, 1.7%), partial thickness flap necrosis (n = 2, 0.9%), pinning back of the ear (n = 2, 0.9%), and central flap dimpling (n = 2, 0.9%). There was 1 acute staphylococcal abscess and 1 sterile abscess that developed 13 months postoperatively. All complications resolved with medical or surgical management.
Transcartilage island pedicle flaps may be considered for single-stage surgical reconstruction of defects involving the anterior ear.
耳部前表面（耳甲、对耳轮、耳舟和三角窝）的手术重建因局部可移动皮肤稀少而变得复杂。
这是一项关于经软骨岛状蒂皮瓣用于重建耳部前手术缺损的回顾性研究。
本研究纳入了232例莫氏显微外科手术缺损病例。该技术包括在耳后沟环形切开皮瓣，通过手术制造的软骨裂隙将皮瓣转移至耳部前方，将皮瓣缝合在耳部前表面，并修复耳后继发缺损。对每个病例的术前、术中和术后细节进行列表和分析。
平均缺损大小为1.9×1.5厘米。并发症包括皮瓣水肿（6例，2.6%）、术后出血（4例，1.7%）、部分厚度皮瓣坏死（2例，0.9%）、耳部后翻（2例，0.9%）和皮瓣中央凹陷（2例，0.9%）。术后13个月出现1例急性葡萄球菌脓肿和1例无菌性脓肿。所有并发症均通过药物或手术治疗得到解决。
对于涉及耳部前方的缺损的单阶段手术重建，可考虑采用经软骨岛状蒂皮瓣。
