鼻翼基底细胞癌手术Ⅰ期修复的探讨

目的探讨侵犯鼻翼软骨的鼻翼基底细胞癌手术Ⅰ期修复的合适方式。方法根据鼻翼缺损的范围、浸润深度对19例鼻翼基底细胞癌采用游离耳廓复合组织瓣和耳廓复合组织瓣联合鼻唇沟皮瓣两种方法进行Ⅰ期修复,并进行随访,分析两种修复方法在鼻翼缺损修复中的优缺点。结果全部病例均手术成功,无皮瓣整体坏死出现。联合修复的12例患者术后均未出现移植物皮肤颜色改变和水疱形成的情况。有1例术后6个月时出现鼻孔边缘粘连导致狭窄,经再次手术恢复正常;1例鼻孔稍外翻。单纯游离耳廓复合组织瓣修复的7例患者中有1例部分组织瓣皮肤有缺血。结论对缺损面积较大（1×1.5cm2～2.0×2.5cm2）、侵犯鼻前庭皮肤的病例可以采用耳廓复合组织瓣联合邻近转移皮瓣进行鼻翼全层修复,而对缺损面积小于1×1.5cm2的病例可以单纯采用耳廓复合组织瓣进行修复。

Primary Surgical Treatment of Alar Basal Cell Carcinoma

Objective To investigate the appropriate way to repair defects of alar after surgery in patients with alar basal cell carcinoma.Methods 19 cases of alar basal cell carcinoma received the primary surgical treatment with free auricular composite flap and auricular composite flap combined nasolabial flap basing on the defect scope and the invasion depth.The advantages and disadvantages of two methods were analyzed.Results All cases were successful,without skin flap necrosis.No skin color change or blisters formation were found in 12 cases of combined remediation.1 case had the nasal stricture 6 months after operation and recovered by reoperation.1 case had the nasal valgus slightly.Among 7 patients with free auricular composite flap,1 case had partial skin ischemia.Conclusions If the defect area is large（1 cm2 × 1.5 cm2 ~ 2.0 cm2 × 2.5 cm2）,auricular composite flap combined nasolabial flap will be the appropriate way to repair of defects of alar,while the defect area is less than 1 × 1.5 cm2,free auricular composite flap may be better.