额部扩张后劈裂双瓣在全鼻再造术中的应用

目的:改良传统额部扩张皮瓣行鼻再造的方法,克服再造术后的鼻外形臃肿、需二次手术整复等不足,提高鼻再造手术的质量。方法:手术分两期进行,一期在额部置入扩张器,扩张完成后,二期将扩张后的额部皮瓣分离成两个组织瓣,即含真皮下毛细血管网的超薄皮瓣和额肌瓣,利用肌瓣包裹鼻假体支架,利用超薄皮瓣完成鼻再造。结果:应用该方法行全鼻再造手术3例,皮瓣均成活良好,手术结果满意。结论:额部扩张后劈裂双瓣行全鼻再造,手术方法简单,解决了传统的额部皮瓣再造鼻手术后的臃肿和需二期整形手术问题,减轻了患者的负担,是值得推广的一种手术方法。

Application of nasal reconstruction by use of the two splitted flap expanded

Objective To overcome the drawback of a clumsy nose,the need of secondary operation and to improve the outcome of the reconstruction,we designed the method of nasal reconstruction by means of improved traditional forehead expanded skin flap.Methods The operation is a two staged process.In the first step,a expander is inserted into the forehead region,and in the second stage the expanded tissue is separated into two portions （a ultrathin skin flap and a frontalis flap）when the expansion completed.The reconstruction of the nose is completed by the use of the ultrathin skin flap and the muscle flap to cover the prosthesis.Results Three patients are cured by this method,all the flaps survived,and a perfect appearance obtained.Conclusion The method of nasal reconstruction by use of the two splitted flap expanded should be recommended to more people for the reason of its advantage of simple technology,resolving the deficient of a fat nose and the need for the second operation of the traditional method,furthermore,it can relieve the patient＇s burden.