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目的:探讨游离双层耳廓复合组织瓣（含耳甲软骨及耳甲前皮肤）在修复全层鼻翼洞穿性缺损中的应用。方法:2016年6月到2019年12月四川省人民医院整形外科收治的单侧全层鼻翼缺损患者的临床资料。切取一侧耳甲游离的双层耳廓复合组织瓣作为鼻腔衬里，外覆带蒂皮瓣的方式进行修复。观察后期游离双层耳廓复合组织瓣存活情况，带蒂皮瓣存活情况，及后期重建鼻翼形态。结果:共纳入12例单侧全层鼻翼缺损患者，女4例，男8例，年龄6~53岁，平均约35.3岁。衬里缺损面积0.7 cm×1.0 cm~2.0 cm×2.6 cm，切取双层耳廓复合组织面积（皮肤) 0.8 cm× 1.0 cm~2.1 cm×2.7 cm, 12例患者均I期愈合，双层耳廓复合组织瓣及带蒂皮瓣均未出现坏死、感染等并发症。整个治疗周期完成后最终获得形态和功能与正常鼻翼相近似的再造鼻翼。末次手术后随访3~32个月，平均约12个月，鼻翼外形良好并未见相关远期并发症。结论:双层耳廓复合组织突破了全层耳廓复合组织瓣游离移植的面积限制；与带蒂皮瓣联合移植缩短了单纯使用皮瓣的治疗周期，更易获得形态逼真的鼻翼。“,”Objective:To discuss the application of free two-layered auriclar composite tissue flap (consisted of auriclar cartilage and the anterior skin) in repairing the full-thickness nasal alar defects.Methods:To analyze the clinical data of patients with unilateral full-thickness nasal alar defect admitted to the plastic surgery department of Sichuan Provincial People's Hospital from June 2016 to December 2019. One side of the concha was excised from the nasal cavity with free two-layered auricular composite grafts as the nasal lining and covered with pedicled skin flap. The survival of free two-layered auricular composite grafts, pedicled skin flap and nasal alar reconstruction were observed.Results:A total of 12 patients with unilateral full-thickness alar defect were included, including 4 females and 8 males, aged from 6 to 53 years, with an average of 35.3 years. The area of lining defect was 0.7 cm × 1.0 cm~2.0 cm × 2.6 cm, and the area of two-layered auricular composite grafts(skin) was 0.8 cm × 1.0 cm~2.1 cm × 2.7 cm. All the 12 patients healed in the first stage. No necrosis or infection occurred in the double auricle composite tissue flap and pedicled skin flap. After the completion of the whole treatment cycle, the reconstructed nasal alar with similar shape and function to the normal nasal alar was obtained. After the last operation, the patients were followed up for 3 months to 32 months, with an average of 12 months.Conclusions:The two-layered auricular composite grafts breaks through the area limitation of free transplantation of full-layer auricle composite tissue flap; the combined transplantation with pedicled flap shortens the treatment cycle of skin flap alone, and it is easier to obtain realistic nasal alar.