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耳前皮瓣修复外耳道缺损的前后对比研究

Comparative study of pre- and postauricular flaps for external auditory canal defect reconstruction.

作者信息

Schonauer Fabrizio, Pezone Giuseppe, Cavaliere Annachiara, D'Andrea Francesco

机构信息

Unit of Plastic Surgery, University Federico II, Naples, Italy, Via Sergio Pansini, 5 - 80131 Napoli.

出版信息

JPRAS Open. 2023 Jul 1;37:121-129. doi: 10.1016/j.jpra.2023.06.005. eCollection 2023 Sep.

Abstract

BACKGROUND

Malignancies involving the external auditory canal deserve critical evaluation due to this area's aesthetic and functional importance. Flaps can be very useful for the restoration of the external auditory canal. A variety of flaps available for the surgical treatment of external acoustic meatus defects exist, depending on the precise location and size.

OBJECTIVES

Our study aimed to compare aesthetic and functional results in the postoncological reconstruction of external auditory canal defects using a preauricular flap and postauricular revolving door flap.

METHODS

Sixteen patients treated at our plastic surgery unit for defects involving the external auditory canal between January 2014 and December 2020 were included in the study. All defects were the result of a primary or secondary skin cancer excision. Patients were divided into two groups, one receiving the preauricular flap technique and the other the postauricular revolving door flap technique.

RESULTS

Three separate visual analog scales reported excellent scores for the two procedures, though the postauricular revolving door flap had slightly better results. Both preauricular flap and postauricular revolving door flap reconstructive techniques showed good options for external auditory canal reconstruction in postexcision skin cancer patients. From an aesthetic point of view, the revolving door flap appeared to be a more elegant surgical approach in this type of reconstruction because the scar was hidden in the postauricular sulcus.

CONCLUSIONS

Reconstruction with a postauricular revolving door flap allowed for a more natural movement with no external pedicle.

EVIDENCE-BASED MEDICINE EBM LEVEL: IV.

摘要

背景

由于外耳道区域在美学和功能上的重要性,涉及外耳道的恶性肿瘤值得进行严格评估。皮瓣对外耳道的修复非常有用。根据精确的位置和大小,有多种皮瓣可用于外耳道缺损的手术治疗。

目的

我们的研究旨在比较使用耳前皮瓣和耳后旋转门皮瓣对外耳道缺损进行肿瘤切除术后重建的美学和功能效果。

方法

纳入2014年1月至2020年12月在我们整形外科接受外耳道缺损治疗的16例患者。所有缺损均为原发性或继发性皮肤癌切除的结果。患者分为两组,一组接受耳前皮瓣技术,另一组接受耳后旋转门皮瓣技术。

结果

三个独立的视觉模拟量表对这两种手术均给出了优异评分,不过耳后旋转门皮瓣的结果略好。耳前皮瓣和耳后旋转门皮瓣重建技术对外耳道切除术后皮肤癌患者的重建均显示出良好的选择。从美学角度来看,旋转门皮瓣在这类重建中似乎是一种更美观的手术方法,因为瘢痕隐藏在耳后沟内。

结论

耳后旋转门皮瓣重建可实现更自然的移动且无外部蒂。

循证医学等级

四级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/026d/10404484/f4cb385087bc/gr1.jpg

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