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耳再造术后多孔高密度聚乙烯框架外露及骨折的修复

Repair of exposure and fracture of the porous high-density polyethylene framework after ear reconstruction.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Institute of Otology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.

Shanghai Key Laboratory for Transitional Medicine of Nose and Ear Diseases, Shanghai, 200011, China.

出版信息

Head Face Med. 2022 Dec 16;18(1):41. doi: 10.1186/s13005-022-00345-y.

Abstract

OBJECTIVE

To assess the repair method of exposure or fracture of the porous high-density polyethylene ear framework after total auricle reconstruction.

STUDY DESIGN

A prospective case study.

METHODS

From April 2018 to October 2021, 11 patients with framework exposure or fracture after total auricle reconstruction were admitted to the hospital for repair. In these 11 patients, the repair was performed using (1) a temporal muscle flap combined with free skin graft in 5 patients, (2) a mastoid fascia flap combined with free skin graft in 2 patients, (3) a simple local skin flap in 1 patient, (4) combination of a temporalis muscle flap and a mastoid fascia flap together with free skin graft in 2 patients, and (5) a Su-Por helix material combined with a temporal muscle flap and free skin graft in 1 patient.

RESULTS

After follow-up for 3-36 months, except for one patient in whom local exposure again occurred at the same site, the framework was in a good shape in the other patients, and all the skin graft survived.

CONCLUSION

The defect of the upper part of the auricle can be repaired using a temporal muscle flap combined with temporal muscle fascia and skin graft. The defect of the middle and lower part of the auricle can be repaired using a mastoid fascia flap combined with skin graft. For framework fracture, the damaged site can be first strengthened with another ear material and then combined with the adjacent fascia flap and free skin graft.

摘要

目的

评估全耳再造后多孔高密度聚乙烯耳支架外露或骨折的修复方法。

研究设计

前瞻性病例研究。

方法

2018 年 4 月至 2021 年 10 月,收治 11 例全耳再造后支架外露或骨折患者,行修复术。其中 5 例行颞肌瓣联合游离皮片修复,2 例行乳突筋膜瓣联合游离皮片修复,1 例行单纯局部皮瓣修复,2 例行颞肌瓣和乳突筋膜瓣联合游离皮片修复,1 例行 Su-Por 螺旋材料联合颞肌瓣和游离皮片修复。

结果

随访 3-36 个月,除 1 例患者同一部位再次出现局部外露外,其余患者支架形态良好,皮片均存活。

结论

上耳缺损可采用颞肌瓣联合颞肌筋膜和皮片修复,中、下耳缺损可采用乳突筋膜瓣联合皮片修复。对于支架骨折,可先用另一只耳朵的材料加固受损部位,再结合邻近筋膜瓣和游离皮片。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/834f/9756489/4b76b74ed29b/13005_2022_345_Fig1_HTML.jpg

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