Acta Chir Plast. 2022 Summer;64(2):62-68. doi: 10.48095/ccachp202262.
The temporoparietal fascia flaps (TPFF) have been widely used to cover the framework in auricular reconstructions. However, flap harvesting is mostly done by open surgery which may be easier but often results in bad scarring and hair loss. We would like to present a series of cases using endoscopic-assisted flap harvesting techniques with only one single cosmetic auricular incision.
Prospective studies from June 2018 to September 2021 on patients who underwent single-stage total auricular reconstruction using autologous costal cartilage and porous polyethylene (PPE) framework. Variables include age, gender, flap survivability as well as visual results and complications.
A total of 61 TPFFs were harvested to cover 15 autologous costal cartilages and 46 PPE frameworks in 60 patients (one patient had operation on both sides). TPFF harvests are performed by endoscopic techniques with one single auricular incision. There was no flap necrosis, no bleeding and no cases required framework removal. Only 7/61 (11.5%) ears had small framework exposure which resolved on their own or only required local skin flap coverage and 1 ear had frontal nerve injury.
Single-stage auricular reconstruction is a difficult surgery, yet greatly beneficial to young children. Through a single-incision endoscopic technique, we can obtain sufficiently large high-survivability TPFFs ensuring full coverage of the autologous costal cartilage or PPE framework. This method is reliable, and reproducible with advanced training. After reviewing the literature, we can state that our report probably includes the largest endoscopic-assisted TPFF harvesting series and the first to implement single-incision endoscopic technique in auricular reconstructions.
颞顶筋膜瓣（TPFF）已广泛用于覆盖耳廓重建的框架。然而，皮瓣的采集大多通过开放式手术完成，虽然这种方法可能更容易，但往往会导致严重的疤痕和脱发。我们将介绍一系列使用内镜辅助皮瓣采集技术的病例，这些病例仅采用一个单一的美容耳廓切口。
对 2018 年 6 月至 2021 年 9 月期间接受自体肋软骨和多孔聚乙烯（PPE）框架一期全耳再造的患者进行前瞻性研究。变量包括年龄、性别、皮瓣存活率以及视觉效果和并发症。
共采集了 61 个 TPFF 来覆盖 60 例患者的 15 个自体肋软骨和 46 个 PPE 框架（1 例患者双侧手术）。TPFF 采集采用内镜技术，仅通过一个单一的耳廓切口进行。没有皮瓣坏死、没有出血，也没有需要移除框架的病例。只有 7/61（11.5%）只耳朵有小面积的框架暴露，这些暴露自行解决或仅需要局部皮瓣覆盖，1 例耳朵有额神经损伤。
一期耳廓重建是一项困难的手术，但对幼儿非常有益。通过单切口内镜技术，我们可以获得足够大、高存活率的 TPFF，确保自体肋软骨或 PPE 框架的完全覆盖。这种方法是可靠的，经过高级培训后可以重复使用。通过文献回顾，我们可以说我们的报告可能包括最大的内镜辅助 TPFF 采集系列，也是第一个在耳廓重建中实施单切口内镜技术的报告。
