Supermicrosurgical reconstruction for congenital aural atresia using a pure skin perforator flap: concept and long-term results.
Supermicrosurgical reconstruction for congenital aural atresia using a pure skin perforator flap: concept and long-term results.
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使用纯皮肤穿支皮瓣进行先天性耳闭锁的超显微外科重建：概念和长期结果。
DOI：
10.1097/prs.0b013e31828bd466
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Koshima I.
中科院分区：
文献类型：
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作者：
Narushima M;Yamasoba T;Iida T;Sakamoto T;Kashio A;Karino S;Yamamoto T;Kikuchi K;Mihara M;Koshima I.
背景：随着临床创新的发展，已经有几种建立外耳道的手术方法。然而，通常需要翻修手术来解决并发症，包括外耳道狭窄、鼓膜偏侧化和慢性复发性耳畸形。这些并发症通常发生在术后6至12个月内。为了减少并发症的发生率，作者使用与植皮一样薄的游离纯皮穿支皮瓣重建先天性外耳道闭锁患者的外耳道和鼓膜。他们报告他们的听力和并发症的结果超过12个月后operation.Methods：作者进行了重建的外耳道和鼓膜9例先天性外耳道闭锁。皮瓣的设计是基于一个纯皮肤穿支来自腹股沟区的8名患者。将皮瓣折叠成约1.5× 3cm的囊，并插入外耳道。结果：单纯穿支皮瓣全部成活，1例表皮部分坏死。听力学随访时间为12 ~ 24个月，平均17个月。平均纯音平均值术前为65.1 dB（范围，53至80 dB），术后改善至32.4 dB（范围，8至53 dB）。这些病例均未出现任何潜在的并发症。结论：这种皮瓣可以减少并发症，并有助于保持听力在长期。
Background:Several surgical methods for creating an external auditory canal have been developed in step with clinical innovation. However, revision surgery is often required to address complications, which include external auditory canal stenosis, lateralization of the tympanic membrane, and chronic recurrent otorrhea. These complications occur frequently within 6 to 12 months after surgery. To decrease the incidence of complications, the authors reconstruct the external auditory canal and tympanic membrane in patients with congenital aural atresia using a free pure skin perforator flap that is as thin as a skin graft. They report their outcomes for hearing acuity and complications over 12 months after the operation.Methods:The authors performed reconstruction of the external auditory canal and tympanic membrane in nine patients with congenital aural atresia. The flap design was based on a pure skin perforator derived from the groin area in eight patients. The flap was folded into an approximately 1.5× 3-cm sac and inserted into the external auditory canal. Anastomosis was performed between the perforator vessels and superficial temporal vessels.Results:All pure skin perforator flaps survived, although one case had partial epidermal necrosis. The audiologic follow-up period ranged from 12 to 24 months (mean, 17 months). The mean pure-tone average was 65.1 dB (range, 53 to 80 dB) preoperatively and improved to 32.4 dB (range, 8 to 53 dB) postoperatively. None of these cases showed any potential complications.Conclusion:This flap may therefore reduce complications and help to maintain hearing acuity in the long term.