合并顱面畸形的小耳畸形耳廓再造術_《中國修復重建外科雜志》

作者：

何樂人 ¹ , 張晉光 ² , 蔣海越 ¹ , 楊慶華 ¹ , 莊洪興 ¹

1中國醫學科學院北京協和醫學院整形外科醫院整形七科（北京，100144）;;
2 北京市通州區潞河醫院整形外科;

關鍵詞：

耳廓再造小耳畸形半側顱面短小征再造耳定位

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目的探討合并顱面畸形的小耳畸形行耳廓再造術的方法及療效。方法回顧分析2000年7月－2010年7月收治的1 300例合并Ⅱ度以上半側顱面短小征的小耳畸形患者臨床資料。男722例，女578例；年齡5歲8 個月～33歲5個月，中位年齡12歲2個月。一期行耳后擴張器植入術，注水擴張完成3～4周后行二期皮膚擴張法耳廓再造術，二期術后6個月～1年1 198例行再造耳修整術。結果28例患者二期術后再造耳外緣部分區域切口愈合不良；其余1 272例切口愈合良好，二期手術拆線后1個月復查，再造耳結構顯露，位置及形態符合術前設計要求。術后200例獲隨訪，隨訪時間1～9年，平均3年。1例因外傷造成耳輪喪失，1例因耳前瘺管感染致再造耳結構大部分喪失。其余患者末次隨訪時手術療效評定：優110例，良65例，欠佳23例；手術療效優良率為88.4%。結論對合并顱面畸形的小耳畸形行耳廓再造的難點是如何達到再造耳與參照耳的對稱，應注意再造耳的定位、耳支架雕刻、殘耳組織的恰當利用。

引用本文： 何樂人,張晉光,蔣海越,楊慶華,莊洪興. 合并顱面畸形的小耳畸形耳廓再造術. 中國修復重建外科雜志, 2012, 26(12): 1477-1481. doi: 復制

1.	Brent B. The correction of microtia with autogenous cartilage grafts: I. The classic deformity? Plast Reconstr Surg, 1980, 66(1): 1-12.
2.	Brent B. The correction of microtia with autogenous cartilage grafts: II. A typical and complex deformities. Plast Reconstr Surg, 1980, 66(1): 13-21.
3.	Brent B. Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases. Plast Reconstr Surg, 1999, 104(2): 319-334.
4.	Nagata S. Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg, 1994, 93(2): 221-230.
5.	Nagata S. Modification of the stages in total reconstruction of the auricle. Part II. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg, 1994, 93(2): 231-242.
6.	Fukuda O. Long-term evaluation of modified Tanzer ear reconstruction. Clin Plast Surg, 1990, 17(2): 241-249.
7.	Song YG, Song YL. An improved one-stage total ear reconstruction procedure. Plast Reconstr Surg, 1983, 71(5): 615-623.
8.	莊洪興, 蔣海越, 潘博, 等. 先天性小耳畸形的皮膚軟組織擴張器法外耳再造術. 中華整形外科雜志, 2006, 22(4): 286-289.
9.	Jiang H, Pan B, Lin L, et al. Ten-year experience in microtia reconstruction using tissue expander and autogenous cartilage. Int J Pediatr Otorhinolaryngol, 2008, 72(8): 1251-1259.
10.	Pan B, Jiang H, Guo D, et al. Microtia: ear reconstruction using tissue expander and autogenous costal cartilage. J Plast Reconstr Aesthet Surg, 2008, 61 Suppl 1: S98-103.
11.	Zhang Q, Quan Y, Su Y, et al. Expanded retroauricular skin and fascial flap in congenital microtia reconstruction. Ann Plast Surg, 2010, 64(4): 428-434.
12.	Jiang H, Pan B, Zhao Y, et al. A 2-stage ear reconstruction for microtia. Arch Facial Plast Surg, 2011, 13(3): 162-166.
13.	Chen Z, Zhang W, Huang J, et al. Exceedingly expanded retroauricular flaps for microtia reconstruction. J Plast Reconstr Aesthet Surg, 2011, 64(11): 1448-1453.
14.	Liu J, Sun J, Li X. Total auricular reconstruction without skin grafting. J Plast Reconstr Aesthet Surg, 2011, 64(10): 1312-1317.
15.	Park C. Subfascial expansion and expanded two-flap method for microtia reconstruction. Plast Reconstr Surg, 2000, 106(7): 1473-1487.
16.	Bauer BS. The role of tissue expansion in reconstruction of the ear. Clin Plast Surg, 1990, 17(2): 319-325.
17.	Hata Y, Umeda T. Reconstruction of congenital microtia by using a tissue expander. J Med Dent Sci, 2000, 47(2): 105-116.
18.	Breugem CC, Stewart KJ, Kon M. International trends in the treatment of microtia. J Craniofac Surg, 2011, 22(4): 1367-1369.
19.	Park C. An algorithm and aesthetic outcomes for a coverage method for large- to medium-remnant microtia: I. Coverage in the one-stage erect position. Plast Reconstr Surg, 2012, 129(5): 803e-813e.
20.	Jinguang Z, Leren H, Hongxing Z. Prevention and treatment of rupture and infection in expanded flaps during auricular reconstruction. J Craniofic Surg, 2010, 21(5): 1622-1625.

1. Brent B. The correction of microtia with autogenous cartilage grafts: I. The classic deformity? Plast Reconstr Surg, 1980, 66(1): 1-12.
2. Brent B. The correction of microtia with autogenous cartilage grafts: II. A typical and complex deformities. Plast Reconstr Surg, 1980, 66(1): 13-21.
3. Brent B. Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases. Plast Reconstr Surg, 1999, 104(2): 319-334.
4. Nagata S. Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg, 1994, 93(2): 221-230.
5. Nagata S. Modification of the stages in total reconstruction of the auricle. Part II. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg, 1994, 93(2): 231-242.
6. Fukuda O. Long-term evaluation of modified Tanzer ear reconstruction. Clin Plast Surg, 1990, 17(2): 241-249.
7. Song YG, Song YL. An improved one-stage total ear reconstruction procedure. Plast Reconstr Surg, 1983, 71(5): 615-623.
8. 莊洪興, 蔣海越, 潘博, 等. 先天性小耳畸形的皮膚軟組織擴張器法外耳再造術. 中華整形外科雜志, 2006, 22(4): 286-289.
9. Jiang H, Pan B, Lin L, et al. Ten-year experience in microtia reconstruction using tissue expander and autogenous cartilage. Int J Pediatr Otorhinolaryngol, 2008, 72(8): 1251-1259.
10. Pan B, Jiang H, Guo D, et al. Microtia: ear reconstruction using tissue expander and autogenous costal cartilage. J Plast Reconstr Aesthet Surg, 2008, 61 Suppl 1: S98-103.
11. Zhang Q, Quan Y, Su Y, et al. Expanded retroauricular skin and fascial flap in congenital microtia reconstruction. Ann Plast Surg, 2010, 64(4): 428-434.
12. Jiang H, Pan B, Zhao Y, et al. A 2-stage ear reconstruction for microtia. Arch Facial Plast Surg, 2011, 13(3): 162-166.
13. Chen Z, Zhang W, Huang J, et al. Exceedingly expanded retroauricular flaps for microtia reconstruction. J Plast Reconstr Aesthet Surg, 2011, 64(11): 1448-1453.
14. Liu J, Sun J, Li X. Total auricular reconstruction without skin grafting. J Plast Reconstr Aesthet Surg, 2011, 64(10): 1312-1317.
15. Park C. Subfascial expansion and expanded two-flap method for microtia reconstruction. Plast Reconstr Surg, 2000, 106(7): 1473-1487.
16. Bauer BS. The role of tissue expansion in reconstruction of the ear. Clin Plast Surg, 1990, 17(2): 319-325.
17. Hata Y, Umeda T. Reconstruction of congenital microtia by using a tissue expander. J Med Dent Sci, 2000, 47(2): 105-116.
18. Breugem CC, Stewart KJ, Kon M. International trends in the treatment of microtia. J Craniofac Surg, 2011, 22(4): 1367-1369.
19. Park C. An algorithm and aesthetic outcomes for a coverage method for large- to medium-remnant microtia: I. Coverage in the one-stage erect position. Plast Reconstr Surg, 2012, 129(5): 803e-813e.
20. Jinguang Z, Leren H, Hongxing Z. Prevention and treatment of rupture and infection in expanded flaps during auricular reconstruction. J Craniofic Surg, 2010, 21(5): 1622-1625.

《中國修復重建外科雜志》

合并顱面畸形的小耳畸形耳廓再造術

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《中國修復重建外科雜志》

合并顱面畸形的小耳畸形耳廓再造術

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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