应用吻合血管的逆行颞浅动脉耳廓复合组织瓣修复鼻缺损

目的设计逆行颞浅血管蒂的游离耳廓组织瓣,探索应用显微外科技术修复鼻部分缺损的新手术方法。方法切取以颞浅血管远端为蒂的耳廓复合组织瓣,应用显微外科技术将颞浅动、静脉远端与面动静脉吻合游离移植修复部分鼻缺损15例,其中鼻翼修复13例,鼻尖修复2例。组织瓣的大小范围为2·5cm×2·0cm~4·0cm×2·5cm,血管蒂的长度为5~8cm,平均6·5cm。结果15例患者游离移植的耳廓复合组织瓣全部成活,重建的鼻翼与健侧对称、鼻尖外形美观。耳廓供区不遗留明显畸形。结论吻合血管的逆行颞浅动脉耳廓复合组织瓣游离移植,血管蒂长,克服了顺行耳廓复合组织瓣血管蒂过短的问题,可成为颞浅动脉耳廓复合组织瓣设计的首选术式。

Microvascular nasal repair using a reversed superficial temporal artery auricular flap

OBJECTIVE: A reversed superficial temporal artery auricular flap was presented to explore a new method for reconstructing the defects of the distal nose by microsurgical techniques. METHODS: A reversed superficial temporal artery auricular flap had been used on fifteen patients with nasal defects, including thirteen patients with alar defects and two patients with nasal tip defects. The reversed superficial temporal vessels of the flap were anastomosed with the recipient facial vessels. The size of the flap was 2.5 cm x 2. 0 cm - 4.0 cm x 2.5 cm, the length of the vascular pedicle was 5 - 8 cm, average 6.5 cm RESULTS: The flap survived uneventfully in all fifteen patients. RESULTS: demonstrated satisfactory symmetry between the reconstructed ala and the contralateral side as well as an excellent tip projection. The donor-site defect was minimal. CONCLUSIONS: The reversed superficial temporal artery auricular flap offers an adequate length of vascular pedicle of the flap, it delivers a good solution to the problem of the vascular pedicle shortage of the proximal superficial artery auricular flap. This technique may become the top choice in the microvascular auricular transfer.