复杂性全鼻缺损的修复重建

鼻缺损加上洞穿性鼻缺损的修复较为困难，本组病例恰当的采用局部皮瓣及瘢痕瓣移植，并在皮瓣移植的方式上，以改传统局部皮瓣旋转推进的方式，为“合页样翻转”方式，避免了蒂部旋转，使切取皮瓣的面积充分利用，增加了覆盖面积，使被封堵的缺损给鼻再造提供了完整基底，两种缺损同时得以修复。鼻再造选用额部扩张后皮瓣和前臂皮瓣为主，并依靠鼻骨缺损程度选用带骨皮瓣转移，取得较满意的效果。

The repair and reconstruction of penetrated nasal defect

It is very difficult to repair a nasal defect with penetrated defect.Local flap andcicatricial flap graft were applied adequately for it in a group of 8 cases.About the modality of flaptransfer,we used a page-liked reverson of flap instead of traditional local rotation and progresion ofnap.We think this method avoid the rotation of flap pedicle,make a full use of the flap,increase thecovering area and make the covered defect as a completed base of the reconstruction of nose.Thus,na-sal defect and its penetrated defect were repaired.Therefore,satisfactory effects were achieved by usingexpanded flap of forehead,flap of forearm and flap with bone according to the extent of nasal bonedefect for the reconstruction of nose.