She Huiming, Chen Xin, Li Gaofeng, Long Xiren
Department of Plastic & Laser Cosmetology, The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha, China.
Ear Nose Throat J. 2024 Oct 13:1455613241291171. doi: 10.1177/01455613241291171.
This case report describes a patient with a left ear deformity resulting from a flame burn sustained 20 years ago. The patient underwent an ear reconstruction procedure utilizing an expanded neck flap. The autologous rib cartilage was used as the framework, while an expanded neck flap served as the covering for the framework. The surgery was completed in 3 stages. Initially, tissue expanders were implanted and gradually inflated with water. After sufficient expansion, the expanders were removed, and the scar tissue was excised. Subsequently, the expanded flap was used to cover the defects, and the expanded neck flap was rotated to cover the autogenous costal cartilage framework obtained intraoperatively. Finally, the reconstructed ear was repaired by constructing the cephaloauricular sulcus, removing postauricular scars, and trimming the neck-flap pedicle. After a 1-year follow-up, the wound had healed satisfactorily with only minor complications. The shape of the reconstructed ear appeared realistic, and its function was maintained. Most of the scars were repaired, and the scarred alopecia was significantly improved. In patients with limited availability of the postauricular flap, especially burn patients, using an expanded neck flap can lead to superior outcomes.
本病例报告描述了一名因20年前火焰烧伤导致左耳畸形的患者。该患者接受了利用扩张颈部皮瓣的耳再造手术。自体肋软骨用作支架，而扩张颈部皮瓣用作支架的覆盖物。手术分3个阶段完成。最初，植入组织扩张器并逐渐注水扩张。充分扩张后，取出扩张器并切除瘢痕组织。随后，使用扩张皮瓣覆盖缺损，将扩张颈部皮瓣旋转以覆盖术中获取的自体肋软骨支架。最后，通过构建颅耳沟、切除耳后瘢痕和修整颈部皮瓣蒂部来修复再造耳。经过1年的随访，伤口愈合良好，仅出现轻微并发症。再造耳的外形逼真，功能得以保留。大部分瘢痕得到修复，瘢痕性脱发明显改善。对于耳后皮瓣可用范围有限的患者，尤其是烧伤患者，使用扩张颈部皮瓣可取得更好的效果。
