From the Department of Plastic and Cosmetic Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University.
Plast Reconstr Surg. 2024 Feb 1;153(2):407e-410e. doi: 10.1097/PRS.0000000000010547. Epub 2023 Apr 13.
Understanding how to remove and retain the relatively large residual auricle is important in concha-type microtia reconstruction. The authors present a method for concha-type microtia reconstruction using a delayed postauricular skin flap. A total of 40 patients with concha-type microtia who underwent ear reconstruction using a delayed postauricular skin flap were retrospectively examined. Reconstruction was performed in three stages. The first stage consisted of preparing a delayed postauricular skin flap and dealing with the residual auricle including removal of the upper residual auricular cartilage. In the second stage, an autogenous rib cartilage framework was placed and covered with a delayed postauricular skin flap, postauricular fascia flap, and autologous medium-thickness skin graft. The ear framework was carefully articulated and secured with the retained residual auricular cartilage to achieve a smooth junction between the two. The third stage involved modification of the reconstructed ear. Patients were followed up for 12 months after ear reconstruction. All reconstructed auricles had a good appearance, and there was a smooth connection between the reconstructed auricle and the residual ear, with similar color as well as a flat and thin scar. All patients were satisfied with the results.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
在 concha 型小耳畸形的重建中，了解如何去除和保留较大的残余耳甲是很重要的。作者提出了一种使用延迟的耳后皮瓣进行 concha 型小耳畸形重建的方法。回顾性检查了 40 例使用延迟的耳后皮瓣进行耳再造的 concha 型小耳畸形患者。重建分为三个阶段。第一阶段包括准备延迟的耳后皮瓣和处理残余耳甲，包括切除上残余耳甲软骨。在第二阶段，放置自体肋软骨框架，并覆盖延迟的耳后皮瓣、耳后筋膜瓣和自体中厚皮片。仔细调整耳架，并将其与保留的残余耳甲软骨固定，以实现两者之间的平滑连接。第三阶段包括对重建耳进行修正。耳重建后随访 12 个月。所有再造的耳甲外形良好，再造耳与残余耳之间连接平滑，颜色相似，且疤痕平坦、纤细。所有患者均对结果满意。
临床问题/证据水平：治疗，IV。
