局部组织瓣整复鼻缺损的临床经验

目的:探索修复鼻翼缺损简单易行、形态效果佳的治疗方法。方法:自1995年以来共收治30例鼻缺损患者,其中额部中央皮瓣3例,以一侧滑车上血管蒂经鼻根皮下隧道穿行到鼻部缺损区;鼻唇沟组织瓣者17例19侧,均设计蒂在上的组织瓣;耳廓全厚三明治式游离瓣10例11侧。结果:额部中央皮瓣3例,鼻唇沟组织瓣17例全部成活;耳廓全厚三明治式游离瓣10例,其中1例首次移植坏死,第2次手术成功。结论:扩张增容后的中央额瓣是全鼻缺损再造的首选治疗方案;整复鼻翼、鼻尖缺损,单侧鼻唇沟皮瓣长度在4～5cm,宽度在1.2～1.5cm为佳。耳廓全厚三明治式游离瓣,宽度在1.8cm以内较安全。

Reconstruction to Nasal Defect with Local Tissue Flaps

Objective: To conclude the experience of local tissue flaps in nasal reconstruction. Methods: 30 cases with nasal defect have been treated in our department since 1995. The forehead central skin flap was used for 3 cases, nasolabial tissue flap was used for 17 cases(19 sides) and the auricular composite tissue flap was used for 10 cases(11 sides). Results: All the forehead central skin flaps and nasolabial tissue flaps survived.1 case treated with auricular composite tissue flap was necrosed, but successed at 2nd operation. Conclusion: The expanded forehead skin flap is the most effective method to reconstruct the nasal defect. Suitable unilateral nasolabial tissue flap is the flap with length of 4～5 cm, and width of 1.2～1.5 cm. Auricular composite tissue flap small than 1.8 cm is safety in clinic.