摘要
目的探讨应用侧鼻动脉为蒂的鼻唇沟皮瓣修复鼻缺损的手术方法及疗效。方法2005年8月-2009年3月,收治鼻缺损患者12例。男5例,女7例;年龄35～60岁,平均48.6岁。其中外伤所致陈旧性鼻缺损5例,病程1～10年;肿瘤切除术后鼻缺损7例,病程3个月～40年。缺损范围为2.0cm×1.5cm～4.5cm×2.5cm。术中采用侧鼻动脉为蒂的鼻唇沟皮瓣修复缺损,其中9例为带蒂皮瓣,3例为轴型岛状皮瓣;皮瓣切取范围为2.5cm×2.0cm～7.0cm×3.0cm。其中5例取自体耳甲腔软骨移植重建鼻翼及鼻尖。供区直接拉拢缝合。结果术后5～24h,3例轴型岛状皮瓣远端出现静脉淤血现象,自行缓解;皮瓣全部成活。供、受区切口均Ⅰ期愈合。5例因皮瓣蒂部略显臃肿,于术后6～15个月行皮瓣修整术。12例患者均获随访,随访时间8～24个月,平均13个月。皮瓣质地柔软、色泽正常,鼻外形良好,无通气障碍。供区无明显瘢痕。结论侧鼻动脉为蒂的鼻唇沟皮瓣距鼻缺损部位近,具有血供丰富、成活率高、皮瓣质地好、供区可直接闭合等优点,是一种修复鼻尖及鼻翼缺损的较好方法。
Objective To evaluate the curative effect of the lateral nasal artery pedicled nasolabial flap for reconstruction of nasal defects. Methods From August 2005 to March 2009,12 cases of large nasal tip and alar defects were repaired with the lateral nasal artery pedicled nasolabial flap. There were 5 male patients and 7 female patients with a mean age of 48.6 years （range,35-60 years）. Five cases of nasal defects were caused by trauma and other defects were caused by excision of carcinoma or hemangioma; the courses of disease were 1 to 10 years and 3 months to 40 years,respectively. The nasal defect size ranged from 2.0 cm × 1.5 cm to 4.5 cm × 2.5 cm. All defects were reconstructed with lateral nasal artery pedicled nasolabial flap in 9 cases and with island flap in 3 cases. The flap size ranged from 2.5 cm × 2.0 cm to 7.0 cm × 3.0 cm. Five patients required cartilage grafts for alar rim support and the distal end of the nasolabial flap was thinned and folded to repair the nasal lining. The donor sites were sutured directly. Results The mild venous stasis at the distal end of three island flaps occurred at 5-24 hours postoperatively and alleviated spontaneously. All flaps survived. Incision at donor and accepted sites healed by fi rst intention. Flap revision was performed in 5 cases after 6-15 months because of mild swelling at the pedicles of skin flaps. All patients were followed up 8-24 months,with an average of 13 months. All patients achieved satisfactory results in nasal appearance,flap texture and color,and ventilatory function. No obvious scar was found at donor sites. Conclusion The nasolabial flap is an excellent choice for reconstruction of defects of nasal tip and ala.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第5期552-555,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
鼻唇沟皮瓣
侧鼻动脉
鼻缺损
修复
Nasolabial flap Lateral nasal artery Nasal defect Repair
