额部带蒂皮瓣全鼻再造术

目的 探讨应用在额部扩张后带蒂皮瓣行全鼻再造术的效果.方法 在前额部的软组织下埋入软组织扩张器,经过8周后将软组织用扩张器注水完成扩张,并持续4～6周.在前额上以一侧知名动脉为血管蒂设计三叶状的带蒂皮瓣,向下反转重建外鼻.结果 7块额部扩张皮瓣转移后完全存活,1例岛状皮瓣转移的患者鼻翼边缘有少许坏死,余5例患者再造鼻的外形与鼻的通气功能均良好,随访9个月至4年8个月,皮瓣无回缩,额部供区无明显瘢痕.结论 额部扩张后带蒂皮瓣为全鼻再造的理想治疗方案,带蒂转移的术式更安全可靠,是一种理想的手术方法.

Total nose reconstruction of the pedicled skin flap

Objective To investigate the effect of the modified expanded forehead pedicled skin flap in total nose reconstruction. Methods The silastic expandably implant was placed under the forehead tissue and water was injected into it. The forehead skin tissue was expanded during 8 weeks and continued for 4 - 6 weeks. A triangle -shaped forehead flap with lateral well-known artery was designed over the expanded forehead skin tissue and used for a nasal defect. Results All the flaps survived. Postoperative follow up for 9 months to 4 years and 8 months showed satisfactory results with good appearance and function. Conclusion It is a preferred method for the repair of nasal defect with expanded forehead flap. The superior volumetric expander can suffice expansion. The methods of pedicle flap transfer are more safe and credible. Using persistence pressure with expansion can get sufficient benefit in effective time and is an ideal operation method.