耳后径路取带蒂皮瓣修复外耳道皮肤缺损18例

doi:10.6040/j.issn.1673-3770.0.2022.250

摘要/Abstract

摘要： 目的探讨应用耳后带蒂皮瓣修复外耳道皮肤缺损扩大外耳道腔的疗效。方法选取16例外耳道胆脂瘤患者及2例外耳道闭锁患者,均在全麻下行手术治疗。经耳后径路,术中见外耳道狭窄、外耳道峡部皮肤环状肉芽生长或闭锁,术中扩大外耳道骨管,于耳后切口处取带蒂皮瓣,向前转入耳道,覆盖于耳道后壁皮肤缺损处,扩大外耳道腔。结果术后所有患者耳道皮瓣均存活,术后6个月,所有患者耳道形态恢复好,未发生狭窄或闭锁。结论耳后径路取带蒂皮瓣易于取材,无需新切口,耳道植皮后,因瓣片有血运、不易坏死,减少了耳道再次狭窄或闭锁的发生。

关键词: 带蒂皮瓣, 外耳道, 皮肤缺损, 修复, 耳后径路

Abstract: Objective This study aimed to repair skin defects and enlarge the cavity of the external auditory canal with retroauricular pedicled flaps. Methods Sixteen patients with external auditory canal cholesteatoma and two patients with external auditory canal atresia were selected for this study. All surgical procedures were performed under general anesthesia through the retroauricular approach. Stenosis of the external auditory canal and annular granulation growth or atresia of the isthmus of the external auditory canal were observed during the operations. The bone canal of the external auditory canal was enlarged. Subsequently, the pedicled skin flap was removed at the retroauricular incision and transferred forward into the auditory canal to cover the skin defect of the posterior wall of the auditory canal and expand the cavity of the external auditory canal. Results The skin grafts of the auditory canal of all patients survived after the operation. The shape of the auditory canal of all patients recovered well 6 months after the operation, without stenosis or atresia. Conclusion The retroauricular pedicled skin flap is easy to obtain without new incisions. After skin grafting of the auditory canal, necrosis is unlikely to occur because of the blood supply to the skin grafts, which reduces the reoccurrence of auditory canal stenosis or atresia.

Key words: Pedicled flap, External auditory canal, Skin defect, Repair, Retroauricular approach

中图分类号:

R764.1

邵永良,周鲲鹏,李广盛,张学梅,杨泽垠. 耳后径路取带蒂皮瓣修复外耳道皮肤缺损18例[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 1-5.

SHAO Yongliang, ZHOU Kunpeng, LI Guangsheng, ZHANG Xuemei, YANG Zeyin. Repairing skin defects 18 cases of the external auditory canal with retroauricular pedicled flaps[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 1-5.

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