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目的 探讨应用多孔高密度聚乙烯 (Medpor)支架耳廓再造的方法 ,提高耳廓再造的形态效果。方法 以Medpor为支架 ,采用耳后乳突区皮肤扩张术 (Ⅰ式 )和颞筋膜瓣并皮片移植术 (Ⅱ式 )两种方法施行全耳廓再造共 112例。其中 ,2 3例采用Ⅰ式手术 ,分两期完成耳廓再造 ;89例采用Ⅱ式手术 ,Ⅰ期完成耳廓再造。结果 112例中 ,成功 10 9例 ,再造耳廓形态较满意 ;失败 3例。该组病例共发生Medpor支架外露 17例 ,其中采用Ⅰ式手术组发生 8例 ,占该组病例的 34% ,采用Ⅱ式手术组发生 9例 ,占该组病例的 10 %。 14例均经Ⅱ期手术用局部皮瓣或局部筋膜瓣并皮片移植获修复 ,3例因支架严重外露无法修复而取出。结论 Medpor支架是耳廓再造可供选择的一种组织代用品 ,用于耳廓再造可取得较好的形态效果。
Objective To explore the method of auricular reconstruction with porous high density polyethylene (Medpor) stent to improve the morphology of auricle reconstruction. Methods One hundred and twelve cases of auricle reconstruction were treated with Medpor as a scaffold and two methods of auricular papillae skin expansion (Ⅰ) and temporal fascia flap and skin graft (Ⅱ). Among them, 23 cases were treated with Ⅰ operation, and the auricle reconstruction was completed in two stages. In 89 cases, Ⅱ operation was performed and stage Ⅰ was completed. Results Among the 112 cases, 109 cases were successful, and the morphology of the auricle was satisfactory. Three cases failed. There were 17 cases of Medpor scaffolds exposed in this group, of which 8 cases occurred in type Ⅰ operation group, accounting for 34% of the cases and 9 cases in type Ⅱ operation group, accounting for 10% of the cases. All the 14 cases were repaired by local skin flap or partial fascia flap and skin grafting after operation of stage Ⅱ, and 3 cases were removed because of severe external exposure of stent. Conclusion The Medpor stent is an alternative tissue substitute for auricle reconstruction, which can be used for auricle reconstruction to achieve better morphological effects.