Abstract：
Objectives: Soft tissue expansion is one of the main methods for autologous cartilage auricular reconstruction. The aim of this study was to analyze the risk factors for cartilage exposure after this method and to describe a surgical method for this complication. Methods: From January 2018 to December 2020, 853 patients (908 sides) underwent auricular reconstruction with an expanded two-flap method at our center. Thirty-two patients experienced cartilage exposure postoperatively. These patients were set as the case group, and 1:1 matched sampling was performed among patients who did not have cartilage exposure. The matched sample of 32 cases was set as the control group. All 64 patients were evaluated according to the Orbit, Mandible, Ear, Nerve, and Soft tissue (OMENS) classification system to analyze the correlation between cartilage exposure and hemifacial microsomia (HFM) and OMENS subtypes. The complication was repaired with superficial temporal fascial flap combined with skin graft. Results: HFM might be a risk factor for scaffold cartilage exposure, and there was a significant correlation between cartilage exposure and orbital malformation, facial nerve dysplasia, and soft tissue developmental malformation. The use of a superficial temporal fascial flap combined with a split-thickness skin graft to repair the complication achieved satisfactory outcomes. Conclusions: There is a correlation between cartilage scaffold exposure and the severity of HFM. Temporoparietal fascial flap transfer combined with skin grafting proved to be an effective method for cartilage exposure.
摘要：
目的:软组织扩张术是自体耳廓软骨重建的主要方法之一。这项研究的目的是分析这种方法后软骨暴露的危险因素，并描述这种并发症的手术方法。方法:2018年1月至2020年12月,853例(908侧)在我中心行扩张双瓣法耳廓重建术。32例患者术后发生软骨暴露。将这些患者设为病例组,在没有软骨暴露的患者中进行1:1匹配的采样。将32例配对样本设为对照组。所有64例患者均根据眼眶进行评估，下颌骨,耳朵,神经,和软组织（OMENS）分类系统，分析软骨暴露与半面微缩肌（HFM）和OMENS亚型之间的相关性。并发症采用颞浅筋膜瓣联合植皮修复。结果:HFM可能是支架软骨暴露的危险因素,软骨暴露与眼眶畸形之间存在显著相关性，面神经发育不良,软组织发育畸形。使用颞浅筋膜瓣结合裂层植皮修复并发症取得了满意的效果。结论:软骨支架暴露与HFM严重程度相关。颞顶筋膜瓣转移联合植皮被证明是软骨暴露的有效方法。
