不同皮瓣修复在外鼻缺损修复中的应用

目的比较不同皮瓣对外鼻不同亚单位缺损修复的效果,总结外鼻不同亚单位缺损的最佳皮瓣修复方式。方法选择2015年8月~2019年1月我科在外鼻皮肤肿瘤切除后进行双叶瓣、鼻唇沟瓣、风筝瓣、耳郭复合组织瓣、菱形皮瓣、Rieger皮瓣修复的病例,比较不同皮瓣修复的优缺点以及修复效果。结果不同皮瓣在外鼻不同亚单位缺损修复中各有优缺点:双叶瓣适合修复鼻尖或鼻翼小而浅的缺损,风筝瓣适合修复周围组织松弛度高的鼻翼或鼻背缺损,鼻唇沟瓣适合修复鼻翼近鼻唇沟处的小缺损,耳郭复合组织瓣适合修复具有软骨缺损的鼻翼缺损,菱形皮瓣适合修复鼻背或鼻根处周围组织松弛的皮肤缺损,Rieger皮瓣适合鼻尖或鼻背处稍大的皮肤缺损。结论对于外鼻不同亚单位的缺损,需选取合适的皮瓣修复,才能在根治肿瘤的基础上获得满意的外形效果。

Application of different flaps in the repair of external nasal defect

Objective To compare the effects of different flaps on different subunit defects of the external nose and to summarize the best flap repair methods for different subunit defects of the external nose.Methods From Aug.2015 to Jan.2019,the patients with bilateral lobe flap,nasolabial groove flap,kite flap,auricle composite tissue flap,Limberg skin flap and Rieger’s skin flap were selected for reconstruction after tumor resection of external nasal skin flap.The advantages and disadvantages of different flaps and the repair effects were compared.Results Different flaps have advantages and disadvantages in repairing defects of different subunits of the external nose:bilateral lobe flap was suitable for repairing the small and shallow defect of nasal tip or alar;Kite flap was suitable for repairing nasal alar or dorsal defect with high degree of tissue relaxation;The nasolabial groove flap was suitable for repairing small defects near the nasolabial groove of the alar;Auricle composite tissue flap was suitable for repairing nasal alar defect with cartilage defect;Limberg skin flap was suitable for repairing skin defects with loose tissue around the dorsum or root of the nose;Rieger flap was appropriate for larger skin defects on the tip or dorsum of the nose.Conclusions For defects of different subunits of the external nose,it is necessary to select appropriate flap in order to obtain satisfactory appearance on the basis of radical treatment of tumors.