鼻部不同亚单位组织缺损修复方法的选择

目的:总结鼻部不同亚单位组织缺损的修复方法,为临床选择不同术式提供参考。方法:2006年2月～2012年1月鼻部不同亚单位组织缺损患者68例,其中采用真皮蒂鼻唇沟皮瓣修复40例,采用耳廓复合组织游离移植修复19例,采用额部皮瓣修复9例。结果:术后皮瓣全部成活;耳廓复合组织游离移植全部成活,供区切口均Ⅰ期愈合。术后患者均获随访,随访时间6个月～3年,平均1年。术后鼻缺损修复良好,鼻外形及通气功能良好,皮瓣色泽、弹性、质地与周围正常皮肤接近。供区鼻唇沟无明显瘢痕,耳廓瘢痕隐蔽,额部植皮部位轻微色差,瘢痕不明显。结论:鼻部不同亚单位组织缺损的修复,应根据缺损部位、范围、深度及缺损周围情况等选择适当的手术方式,以达到良好的修复效果。

Choice of methods for repairing defects of different nasal subunits

Objective To review methods for repairing defects of different nasal subunits, and to provide the most proper choice for clinical reference, Methods 68 patients with different nasal subunit-defects during February 2006 to January 2012, were repaired respectively with dermal pedicled nasolabial flap （40 cases）, auricular composite graft （19 cases）, and frontal flap （9 cases）. Results All flaps and auricular composite grafts survived, and incisions at donors and wound healed by first intention. After operation, all patients were followed up 6 months-3 years （mean, 1 year）. Nasal defects were repaired with better nasal contour and ventilation function. The texture and color of the flap were similar to adjacent skin. A slight difference appeared on the frontal skin grafting area. No obvious scar was observed at donor sites （nasolabial fold,auricle and forehead）. Conclusion Choosing a proper method to repair the defects of different nasal subunits should depend on the site, scope and depth of the defects and the local situations to get the satisfactory effects.