改良Nagata法耳再造术在烧伤后部分耳廓缺损修复中的应用-《中国美容医学》

文章信息/Info

Title:: Application of Modified Nagata Auricular Reconstruction in the Repair of Postburn Auricle Defect

Author(s):: LI Chunlian; WANG Fan; LIU Linqi; ZHANG Can; CHAI Linlin; (Department of Plastic and Aesthetics,First Affiliated Hospital,Army Medical University,Chongqing 400038,China)

Keywords:: auricle defect; auricular reconstruction; autologous costal cartilage framework; burn; scar

摘要:: 目的：总结采用改良Nagata法对烧伤后部分耳廓缺损进行再造的手术方法及临床疗效。方法：手术分两期进行，一期使用患者自体肋软骨雕刻行成耳支架，沿耳后瘢痕做切口并在皮下潜行分离，形成腔隙，植入支架；二期颅耳沟形成，采用耳后筋膜瓣转移覆盖基座支架并植皮。结果：随访6个月～2年，再造耳效果均满意，解剖结构清晰，耳廓的位置大小和对侧较相似，移植的软骨支架无吸收变形，术后3例发生伤口愈合不良，经治疗均愈合良好。结论：对于烧伤后部分耳廓缺损，采用改良Nagata二期法进行耳再造修复，缩短了治疗周期，术后并发症较少，再造耳结构清晰，总体效果满意。

Abstract:: Objective To explore the surgical skills and clinical effect of the modified Nagata method for reconstruction of auricle defect after burn. Methods The operation was divided into two stages. In the first stage, an incision was made along the post-auricular scar and separated subcutaneously to form a cavity, an autologous costal cartilage framework was sculpted, assembled, and then implanted. In the second stage, the autologous cartilage framework was lifted, covered with a retro-aur ical fascia flap and medium thickness skin graft. The cranioauricular sulcus was formed. Results After 6 months to 2 years of follow-up, the effect of reconstructed ear was satisfactory, the anatomical structure was clear, the position and size of auricle were similar to the contralateral side, the transplanted cartilage scaffold had no absorption and deformation, 3 cases had poor wound healing after operation, and all healed well after treatment. Conclusion The improved Nagata two-stage method can be used for post -burn partial ear reconstruction. It could shorten the treatment time, has fewer postoperative complications. The reconstructed ear has defined structure and the overall effect is satisfactory.