大腿内侧Thiersch皮瓣在小耳畸形耳廓成形并外耳道重建术中的应用

Application of inner thigh Thiersch skin flap to the reconstruction of auricle and external auditory canal in microtia patients

摘要:

目的探讨小耳畸形患者采用大脚内侧Thiersch皮瓣在耳廓成形并外耳道重建术中的应用。方法 总结2000年1月~2012年5月先天性小耳畸形并外耳道闭锁的患者105例（115耳）临床资料，所有患者在全麻下行耳廓成形并外耳道重建术，在重建的外耳道内采用大腿内侧Thiersch皮瓣移植，术后10~12 d局部换药，3~4周后外耳道用透明质酸和膨胀海绵填塞，3~6个月后取出填塞物。结果耳廓外形满意，外耳道皮肤上皮化良好，112耳外耳道口直径6~10 mm，外耳道口宽敞；3例患者因未定期复诊出现外耳道狭窄。结论大腿内侧Thiersch皮瓣可满足于先天性小耳畸形术后外耳道植皮需要，术后定期复查可有效预防外耳道狭窄。

关键词:小耳畸形|外耳道重建术|Thiersch皮瓣

Abstract:

ObjectiveTo explore the application of inner thigh Thiersch skin flap to the reconstruction of auricle and external auditory canal in microtia patients.MethodsClinical data of 105 patients (115 ears) with congenital microtia and aural atresia, hospitalized in our department from January 2000 to May 2012, was analyzed retrospectively. All patients underwent synchronous reconstruction of auricle and external auditory canal under general anesthesia. The reconstructed external auditory canal was lined and fixed by Thiersch skin flap acquired from inner thigh. Local dressing got changed 10-12 days after operation. 3 to 4 weeks postoperatively, the reconstructed external auditory canal was plugged with hyaluronic acid and expansion sponge which were removed 3 to 6 months afterwards. ResultsThe openings of external auditory canal in 112 patients were wide enough (6 mm~10 mm in diameter) with satisfactory shape of auricle and well epithelization of skin of external auditory canal.ConclusionInner thigh Thiersch skin flaps can meet the needs for skin transplant in postoperative external auditory canal in patients with microtia and can effectively prevent stenosis of external auditory canal with proper postoperative management.

Key words:Microtia|External acoustic meatoplasty|Thiersch skin flap