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耳甲软骨移植及耳后皮瓣覆盖重建耳廓上三分之一缺损。

Reconstruction of Upper Third Defect of the Auricle by Conchal Cartilage Graft and Coverage by Postauricular Flap.

机构信息

Plastic and Reconstructive Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Plastic and Reconstructive Surgery Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

出版信息

Ann Otol Rhinol Laryngol. 2024 Feb;133(2):196-204. doi: 10.1177/00034894231195665. Epub 2023 Sep 9.

Abstract

BACKGROUND

The defects of the upper third of the auricle are considered significant reconstructive challenges, as they require frequent operations with a high risk of morbidity at the donor site and result in unacceptable cosmetic abnormalities.

OBJECTIVE

Is to perform the reconstruction of a full-thickness auricular defect located in the upper third of the ear using a conchal cartilage graft with postauricular flap coverage, aiming to minimize both donor and recipient morbidity.

PATIENTS AND METHODS

The current study included 20 patients with unilateral upper-third auricular defects. The repair involved 2 components: a cartilage graft from the concha to provide structural support and a flap for coverage. Follow-up was conducted for 6 months after the operation.

RESULTS

Successful outcomes were achieved in both subjective and doctors' assessments. Regarding subjective outcomes, 85% of the patients reported high satisfaction ( < .001). In terms of doctors' subjective assessment, 90% of the patients had excellent results ( < .001). Mild early and postoperative complications, if encountered, resolved spontaneously.

CONCLUSION

The use of a combined conchal cartilage graft and postauricular flap in treating a full-thickness upper third auricular defect is safe and effective, with no major complications. The technique preserves the cosmetic and functional outcomes of the auricle, providing an excellent color match and minimal donor-site morbidity.

摘要

背景

耳上部的缺损被认为是具有重大挑战性的重建问题,因为它们需要频繁手术,供区的发病率高,并且导致不可接受的美容畸形。

目的

使用耳后皮瓣覆盖的耳甲腔软骨移植物对全厚耳上部缺损进行重建,旨在将供区和受区的发病率降至最低。

患者和方法

本研究纳入了 20 例单侧耳上部全层缺损患者。修复包括 2 个部分:耳甲腔软骨移植物提供结构支撑,皮瓣用于覆盖。术后随访 6 个月。

结果

主观和医生评估均取得了成功的结果。在主观评估方面,85%的患者报告高度满意(<0.001)。在医生的主观评估方面,90%的患者结果为优秀(<0.001)。如果出现轻度早期和术后并发症,会自行消退。

结论

在治疗全厚耳上部缺损时,使用联合耳甲腔软骨移植物和耳后皮瓣是安全有效的,没有重大并发症。该技术保留了耳廓的美容和功能效果,提供了极好的颜色匹配和最小的供区发病率。

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