利用Ⅲ度小耳畸形残耳组织行再造耳耳屏及 耳甲腔成形.

Objective To explore the application of totally expanded skin for auricular reconstruction in patients with grade III microtia. To reconstruct tragus and concha cavity by rational utilization of remnant ear. Methods There were 36 patients suffered from microtia with remnant ear in the new method group. In the first stage of operation, a tissue expander of 150 ml was implanted to the dual- plane of postauricular mastoid region through the incision of remnant ear. In the second stage, autologous costal cartilage framework was implanted for auricular reconstruction. In the third stage, the skin of remnant ear was designed to reconstruct the tragus and cover partial wounds of the concha cavity. The cartilage of remnant ear was used as the internal support of tragus or inserted to the bottom to increase the height of framework. There were 46 patients in the traditional expansion group. In the third stage of operation, the remnant earlobe was transferred to reconstruct earlobe. The tragus was reconstructed by M flap. The free skin graft was applied for concha cavity. All patients were followed up from 6 to 12 months, the size of tragus and concha cavity and satisfaction of patients were evaluated. Results No obvious scar was found on the surface of reconstructed auricle in the new method group. A blister of 0.6 cm × 0.4 cm at distal remnant earlobe flap was found in 1 patient and cured after dressing change of 10 days. In the traditional expansion group, blister was found in skin graft of concha cavity in 5 patients and cured after dressing change. During the follow-up, the contracture and deformity of tragus and retraction rate of concha cavity was less than that of the traditional expansion group. The patients' satisfaction of the new method group was significantly higher than that of the traditional expansion group (P<0.05). The fullness of reconstructed earlobes was slightly worse than normal. ConIIIclusion Enough skin could be expanded to totally covered the surface of the whole cartilage framework. There was no need for earlobe transposition. No surgical scar was found on the framework surface of the reconstructed ear. The remnant ear could be adequately used. The appearance of tragus and concha cavity of reconstructed ear was good. [ABSTRACT FROM AUTHOR]