摘要目的 探讨应用耳后皮肤和头皮联合扩张皮瓣重建自然美观的鬓角的临床效果.方法 回顾性分析中国医学科学院整形外科医院整形九科2014年1月至2017年12月接受耳后皮肤和头皮联合扩张皮瓣鬓角再造术的患者的临床资料,共20例,男12例(12侧),女8例(9侧),年龄(23.8±3.2)岁.其中烧伤后鬓角缺失19例,鬓角区血管瘤1例.采用扩张的耳后皮肤联合头发瓣通过单蒂或双蒂转移至耳前进行鬓角再造.结果 人组的20例患者共再造21侧鬓角,术中切取皮瓣面积8 cm ×12 cm～10 cm×16 cm,其中1例术后皮瓣远端发生静脉淤血,经过积极换药处理痊愈,鬓角形态未受影响,其余皮瓣均成活良好,重建的鬓角外观自然,并且与健侧鬓角形态、位置基本对称.皮瓣供区瘢痕隐藏于新形成的耳后发际线中.术后随访3～40个月,其中14例非常满意,6例比较满意.结论 耳后皮肤头皮联合扩张皮瓣转移重建的鬓角,具有完全正常的毛发皮肤分界线,毛发密度及生长方向符合自然鬓角的结构,且瘢痕隐蔽,患者满意度高.

abstractsObjective To introduce a reconstruction procedure of natural sideburn,with combined expanded retroauricular flap and scalp flap.Methods A retrospective study was produced in Plastic Surgery Hospital,PUMC,from January 2014 to December 2017.Twenty patients (21 sides) underwent sideburn reconstruction with combined expanded retroauricular flap and scalp flap (double pedicled flap,n=3;single pedicled flap,n=17) were included in this study.There were 12 male (12 sides) and 8 female (9 sides),with the mean age of (23.8±3.2) years.The sideburn defect was caused by burn in 19 patients,and it was resulted from hemangioma in 1 patient.Results The size of flaps ranges from 8 cm×12 cm to 10 cm×16 cm.Venous congestion at the distal end of the flap occurred in 1 patient,which was cured after dressing change,and the sideburn was not affected.The reconstructed sideburns are natural,symmetric,and without obvious scar.The follow-up time was 3-40 months.Fourteen patients were very satisfied with the reconstructed sideburn,and 6 patients were satisfied.No severe complication was observed during follow-up time.Conclusions The combined retroauricular flap and scalp flap is an alternative method for sideburn reconstruction,which provide natural hair distribution,inconspicuous scars and less complications.