目的 探讨应用自体肋软骨移植再造耳廓治疗Ⅱ度小耳畸形的临床效果。方法 选取2019-01至2023-12武警山东总队医院收治15例Ⅱ度小耳畸形为研究对象,根据患者健侧耳廓的大小位置形态及患耳耳廓形状,应用自体肋软骨个性化雕刻需要再造的部分耳廓软骨支架,使其具备缺损的部分耳轮、对耳轮等结构。松解分离皮肤制作皮瓣,将雕刻好的软骨支架植入缺损的耳轮及对耳轮处,完全包裹耳廓支架与残耳结构。观察手术后效果,并随访1年观察并发症,调查患者满意度。结果 15例术后切口均为Ⅰ期愈合,无血肿、感染、皮肤坏死等并发症发生。术后部分再造耳与残耳衔接自然,耳轮、对耳轮、耳舟等结构立体逼真,患耳整体与健耳形状相似,位置相近,未出现软骨外露、耳廓变形等问题。15例中有12例患者对术后效果很满意,3例患者一般满意,满意度为100%。结论 应用自体肋软骨移植法行部分耳廓再造术个性化治疗Ⅱ度小耳畸形,效果良好,术后并发症少,患者满意度高。
Abstract
Objective To explore the therapeutic effect of partial auricular reconstruction with autologous rib cartilage in the treatment of grade Ⅱ microtia. Methods From January 2019 toDecember 2023, 15 grade Ⅱ microtia patients were treated. Based on the size, position, and shape of the patient's healthy ear and the shape of the affected ear, personalized carving of partial ear cartilage scaffolds using autologous rib cartilage was applied to make them have missing structures such as the helix and antihelix. We released and separated the skin to create a skin flap, and implanted the carved cartilage scaffold into the missing location of the helix and antihelix which completely wrapped the auricle scaffold and residual ear structure. After Observed the postoperative effect and one-year follow-up to observe complications,we investigated patient satisfaction. Results All 15 patients had stage I wound healing after surgery, and no complications such as hematoma, infection, or skin necrosis occurred.After surgery, the partially reconstructed ear was naturally connected to the residual ear, with three-dimensional and realistic structures such as the helix, antihelix, and scapha.The affected ear had a similar overall shape and position to the healthy ear. There was no issues such as cartilage exposure or auricular deformation. Among the 15 patients, 12 were very satisfied with the postoperative results, and 3 were generally satisfied, with a satisfaction rate of 100%. Conclusions The application of autologous rib cartilage transplantation in partial auricular reconstruction for personalized treatment of grade II microtia has good results and fewer postoperative complications, which is worthy of clinical application and promotion.
关键词
小耳畸形 /
自体肋软骨 /
手术治疗
Key words
microtia /
autogenous costal cartilage /
surgical treatment
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参考文献
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基金
军队保健和计生专项科研课题(22JSZ08)
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