• 1中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)學(xué)院整形外科醫(yī)院整形七科（北京，100144）;;
  • 2 北京市通州區(qū)潞河醫(yī)院整形外科;

目的 探討合并顱面畸形的小耳畸形行耳廓再造術(shù)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(cè)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(kuò)張器植入術(shù)，注水?dāng)U張完成3～4周后行二期皮膚擴(kuò)張法耳廓再造術(shù)，二期術(shù)后6個月～1年1 198例行再造耳修整術(shù)。 結(jié)果28例患者二期術(shù)后再造耳外緣部分區(qū)域切口愈合不良；其余1 272例切口愈合良好，二期手術(shù)拆線后1個月復(fù)查，再造耳結(jié)構(gòu)顯露，位置及形態(tài)符合術(shù)前設(shè)計要求。術(shù)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(jié)構(gòu)大部分喪失。其余患者末次隨訪時手術(shù)療效評定：優(yōu)110例，良65例，欠佳23例；手術(shù)療效優(yōu)良率為88.4%。 結(jié)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(dá)到再造耳與參照耳的對稱，應(yīng)注意再造耳的定位、耳支架雕刻、殘耳組織的恰當(dāng)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(shù). 中國修復(fù)重建外科雜志, 2012, 26(12): 1477-1481. doi: 復(fù)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(kuò)張器法外耳再造術(shù). 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. 1. Brent B. The correction of microtia with autogenous cartilage grafts: I. The classic deformity? Plast Reconstr Surg, 1980, 66(1): 1-12.
  2. 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. 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. 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. 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. 6. Fukuda O. Long-term evaluation of modified Tanzer ear reconstruction. Clin Plast Surg, 1990, 17(2): 241-249.
  7. 7. Song YG, Song YL. An improved one-stage total ear reconstruction procedure. Plast Reconstr Surg, 1983, 71(5): 615-623.
  8. 8. 莊洪興, 蔣海越, 潘博, 等. 先天性小耳畸形的皮膚軟組織擴(kuò)張器法外耳再造術(shù). 中華整形外科雜志, 2006, 22(4): 286-289.
  9. 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. 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. 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. 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. 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. 14. Liu J, Sun J, Li X. Total auricular reconstruction without skin grafting. J Plast Reconstr Aesthet Surg, 2011, 64(10): 1312-1317.
  15. 15. Park C. Subfascial expansion and expanded two-flap method for microtia reconstruction. Plast Reconstr Surg, 2000, 106(7): 1473-1487.
  16. 16. Bauer BS. The role of tissue expansion in reconstruction of the ear. Clin Plast Surg, 1990, 17(2): 319-325.
  17. 17. Hata Y, Umeda T. Reconstruction of congenital microtia by using a tissue expander. J Med Dent Sci, 2000, 47(2): 105-116.
  18. 18. Breugem CC, Stewart KJ, Kon M. International trends in the treatment of microtia. J Craniofac Surg, 2011, 22(4): 1367-1369.
  19. 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. 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.