旋转皮瓣在耳郭断离伤中的应用

doi:10.6040/j.issn.1673-3770.0.2014.050

摘要/Abstract

摘要： 目的探讨耳郭中上部不全或完全断离伤的修复方法。方法 11例中不全断离伤10例，将断耳与残耳相连侧的皮肤尽量保留并对位缝合，去掉断耳对侧皮肤，取邻近皮瓣修复断耳皮肤缺损。1例咬伤致耳郭上部“U”形缺损，断耳丢失，去掉缺损前方耳郭前、后面皮肤，取耳轮脚至耳屏软骨前方皮瓣连同耳屏软骨修复前方缺损，耳后乳突区旋转皮瓣修复缺损后方耳郭皮肤缺损。结果随访6个月～8年，11例患者断耳全部成活，外形满意，耳郭无明显畸形。结论对耳郭中上部较小的断离伤，如为不全断离伤，可将断耳与残耳相连侧的皮肤尽量保留并对位缝合，去掉断耳对侧皮肤，取邻近皮瓣修复断耳皮肤缺损。略小于耳屏的耳郭中上部全层缺损，可取带有耳屏软骨的耳前复合组织瓣和耳后旋转皮瓣修复。

关键词: 旋转皮瓣, 断离伤, 外科手术, 耳郭

Abstract: Objective To investigate the techniques to repair partial or total auricle avulsions at the middle-upper part. Methods In the repair of ten partially injured auricles, the skin at the side of the injury connected with the normal was reserved as much as possible and sutured directly, while the skin at the opposite side of injured auricle was removed, and the skin defect was repaired with adjacent skin flap. One auricle was bitten off and lost. For such a U shape defect, the skin at both sides of the remnant auricle was removed and repaired with a flap formed by the skins from crus of helix to tragus combined with the tragic cartilage. Results The patients were followed up from six months to eight years. All the auricles recovered well with good shapes and without obvious deformities. Conclusions To the partial or total auricle avulsions injured at the middle-upper part, the skin at the side of the injury connected with the normal can be sutured directly. The skin at the opposite side of the injury, the skin defect can be repaired with adjacent skin flap. If the defect of the auricle at the middle-upper part is a little smaller than tragic cartilage, it can be repaired with pre-auricular composite tissue flap and post-auricular rotation skin flap.

Key words: Auricle, Surgical procedures, Rotation skin flap, Avulsion

中图分类号:

R764.91

宋盛华, 赵伟, 蒋金琴, 赵梦莹. 旋转皮瓣在耳郭断离伤中的应用[J]. 山东大学耳鼻喉眼学报, 2014, 28(5): 29-33.

SONG Sheng-hua, ZHAO Wei, JIANG Jin-qin, ZHAO Meng-ying. Application of rotation skin flap in the repair of auricle injuries[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2014, 28(5): 29-33.

参考文献

[1] 赵彧,元晶,侯严可.耳郭外伤的急诊整形修复体会[J]. 山东大学耳鼻喉眼学报,2012,26(3):90-91. ZHAO Yu, YUAN Jing, HOU Yanke. Auricle trauma plastic surgery for repairing experience[J]. J Otolaryngol Ophthalmol Shandong University, 2012, 26(3):90-91.
[2] 冯和同,万玉柱.耳郭外伤36例[J]. 山东大学耳鼻喉眼学报,2009,23(1):52-53. FENG Hetong, WAN Yuzhu. Auricular trauma in 36 cases of[J]. J Otolaryngol Ophthalmol Shandong University, 2009, 23(1):52-53.
[3] 宋西成,张庆泉,陈秀梅,等.外鼻基底细胞癌切除及一期修复[J].中华耳鼻咽喉头颈外科杂志,2012,47(2):142-146. SONG Xicheng, ZHANG Qingquan, CHEN Xiumei, et al. The external nasalbasal cell carcinoma resection and one stage repair[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2012, 47(2):142-146.
[4] 潘新良.头颈部组织缺损修复与功能重建[J]. 中华耳鼻咽喉头颈外科杂志,2011,46(5):355-357. PAN Xinliang. Repair and functional reconstruction in treatment of head and neck tissue defect[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2011, 46(5):355-357.
[5] 张彬.面部皮肤癌手术缺损修复的常用局部皮瓣[J]. 中华耳鼻咽喉头颈外科杂志,2011,46(5):433-436. ZHANG Bin. How to reconstruct the surgical defects of facial skin tumor with local flaps[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2011, 46(5):433-436.
[6] 安增喜,李筱勇,侯晓丰,等.面颈部皮肤组织缺损修复32例[J]. 山东大学耳鼻喉眼学报,2012,26(2):69-70. AN Zengxi, LI Xiaoyong, HOU Xiaofeng, et al. 32 cases of facial and neck skin defect[J]. J Otolaryngol Ophthalmology Shandong University, 2012, 26(2):69-70.
[7] 熊绍虎,徐传达,程新德,等.面部真皮下血管网皮瓣血供的解剖学基础[J].中国临床解剖学杂志,2000,18(4):330-332. XIONG Shaohu, XU Chuanda, CHENG Xinde, et al. Anatomical basis of the blood supply of facial subdermal vascular network flap[J]. Chin J Clin Anatomy, 2000, 18(4):330-332.
[8] 周健,孙庚林,吴炜,等.面颈部切割伤30例的临床救治分析[J]. 中华耳鼻咽喉头颈外科杂志,2012,47(2):152-153. ZHOU Jian, SUN Genglin, WU Wei, et al. Analysis of clinical treatment of face and neck cut injury in 30 cases[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2012, 47(2):152-153.
[9] 郑美桦,张秀慧.耳郭断离再植成活一例[J].中华耳鼻咽喉头颈外科杂志,2005,40(6):451. ZHEN Meihua, ZHANG Xiuhui. The auricle of replantation of severed survival of 1 cases[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2005, 40(6):451.
[10] 苏法仁,薄林,丁静华,等.外伤后耳郭缺损的修复[J].山东大学耳鼻喉眼学报,2013,27(1):37-39. SU Faren, BO Lin, DING Jinghua, et al. Repairing auricle defect after trauma[J]. J Otolaryngol Ophthalmol Shandong University, 2013, 27(1):37-39.

相关文章 15

[1]	王丽,张宇,张华,刘雪艳,宋西成. 加速康复外科理念在鼻窦外科手术的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 23-26.
[2]	王春雨,张芬,王贝贝,李宇玥,王小雨,李志云,张庆泉. 喉白斑32例临床诊治分析及再认识[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 114-116.
[3]	宋西成. 加速康复外科理念在头颈肿瘤手术的应用价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 1-4.
[4]	李华斌, 赖玉婷. 慢性鼻-鼻窦炎的发病机制及诊疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 4-9.
[5]	张炜,曾昱菡,余先崧. 慢性鼻窦炎手术前后ECP、EGF、IL-6的水平变化及临床意义[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 63-67.
[6]	刘晓静,王愿,张立庆,冯剑,赵青,宋圣花,周涵,董伟达. 鼻窦骨纤维异常增殖症36例临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 73-78.
[7]	王愿,周涵,刘晓静,张立庆,赵青,冯剑,董伟达. 鼻内翻性乳头状瘤的术式选择和疗效分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 79-83.
[8]	朱丽. 近期鼻骨与鼻中隔复合外伤鼻内镜下成形术[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 7-9.
[9]	李娜. 美容与功能兼顾——浅谈鼻畸形整复与鼻中隔成形术[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 1-2.
[10]	吴晴伟,赵影颖,王珮华,王钟颖,陈东. 鼻尖鼻背缺损延期局部皮瓣修复的疗效观察[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 14-17.
[11]	华骋, 陈振雨,张维娜,李娜. 鼻内镜辅助下外鼻整形同期鼻中隔偏曲矫正术[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 33-36.
[12]	姜震,雷大鹏,刘大昱,孙睿杰,于学民,李学新,林云,潘新良. 颈根部占位性病变的诊断与治疗[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 53-55.
[13]	李俏丽,李超,王薇,蔡永聪,孙荣昊,周雨秋,税春燕, 黄璐,涂静. 术后放化疗后复发并侵及侧颅底的原发性腮腺鳞状细胞癌一例[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 87-88.
[14]	江英,陈玥竹,饶郁芳,唐玥玓. 鼻中隔-鼻整形术矫正严重外伤性鼻畸形伴鼻中隔偏曲一例[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 45-47.
[15]	孙国臣,孙彦,张虹,王保为. 儿童分化型甲状腺癌的临床特征及治疗体会[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 25-28.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed