以侧鼻动脉为蒂的鼻唇沟皮瓣修复多个亚单位鼻缺损的疗效
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摘要
目的:总结以侧鼻动脉为蒂的鼻唇沟皮瓣修复多个亚单位的鼻缺损的疗效。方法:2014-09-2016-04期间应用鼻唇沟皮瓣治疗多个亚单位的鼻缺损患者30例,术中采用以侧鼻动脉为蒂的鼻唇沟皮瓣修复缺损。结果:30例患者皮瓣全部成活,供区Ⅰ期愈合。术后24h内有2例患者出现静脉淤血现象,后自行缓解。25例于术后3~6个月行皮瓣修形术,23例患者获3~12个月随访。患者均对外观满意。结论:以侧鼻动脉为蒂的鼻唇沟皮瓣能够修复大面积的多个亚单位的鼻缺损,质地、颜色、厚薄与周围皮肤相近,是修复多个亚单位鼻缺损的有效方法之一。
Objective:To evaluate the effectiveness of the lateral nasal artery pedicled nasolabial flap for reconstruction of nasal defects of multiple subunits.Method:From September 2014 to April 2016,30 cases of nasal defects in multiple subunits repaired with the lateral nasal artery pedicled nasolabial flap were retrospectively analysed.Result:All flaps survived.Incision at donor and accepted sites healed by first intention.Two patients had mild venous stasis 24 hours after operation and can alleviated spontaneously.Flap revision was performed in 25 cases after 3-6 months.Twenty-three cases were followed up 3-12 months.All patients achieved satisfactory results in nasal appearance.Conclusion:The lateral nasal artery pedicled nasolabial flap can reconstruct the nasal defects of multiple subunits,and the texture,color or thickness are similar to the surrounding skin.It is one of the effective methods to repair multiple subunits of nasal defects.
Objective:To evaluate the effectiveness of the lateral nasal artery pedicled nasolabial flap for reconstruction of nasal defects of multiple subunits.Method:From September 2014 to April 2016,30 cases of nasal defects in multiple subunits repaired with the lateral nasal artery pedicled nasolabial flap were retrospectively analysed.Result:All flaps survived.Incision at donor and accepted sites healed by first intention.Two patients had mild venous stasis 24 hours after operation and can alleviated spontaneously.Flap revision was performed in 25 cases after 3-6 months.Twenty-three cases were followed up 3-12 months.All patients achieved satisfactory results in nasal appearance.Conclusion:The lateral nasal artery pedicled nasolabial flap can reconstruct the nasal defects of multiple subunits,and the texture,color or thickness are similar to the surrounding skin.It is one of the effective methods to repair multiple subunits of nasal defects.
引文
[1]JIN H R,JEONG W J.Reconstruction of nasal cutaneous defects in Asians[J].AurisNasus Larynx,2009,36:560-566.
[2]徐梁,俞哲元,袁捷,等.鼻面沟带蒂皮瓣在鼻部亚单位缺损修复中的应用[J].组织工程与重建外科杂志,2016,12(3):174-176.
[3]邵英,张舵,赵自然,等.侧鼻动脉为蒂的鼻唇沟皮瓣修复鼻缺损[J].中国修复重建外科杂志,2010,24(5):526-527.
[4]岳毅刚,李佩英,秦小云.鼻唇沟任意型皮瓣血供的解剖学基础[J].中国临床解剖学杂志,2002,20(4):259-260.
[5]MAHER I A,LAVIGNE K.Use of the standing cone allows for subunit repair of a large composite cheek and nose defect[J].Dermatol Surg,2014,40:1255-1258.
[6]王炜.整形外科学[M].杭州:浙江科学技术出版社,1999:1045-1045.
[7]宋可新,王友彬,黄渭清,等.鼻部浅表肿物切除后的创面修复[J].中华损伤与修复杂志(电子版),2014,9(1):55-56.
[8]LINDSAY K J,MORTON J D.Flap or graft:The best of both in nasal ala reconstruction[J].J Plast Reconstr Aesthet Surg,2015,68:1352-1357.
[9]AKDAGLI S,LEE M K,MOST S P.Bilobeflap with auricular cartilage graft for nasal alar reconstruction[J].Am J Otolaryngol,2015,36:479-483.
[10]LIN W,QING Y,LIU J,et al.Alar flap combined with free auricular composite flap for the reconstruction of nasal alar defect[J].J Craniofac Surg,2015,26:562-564.
[11]郭澍,韩思源,卢利,等.鼻唇沟皮瓣在鼻唇缺损修复中的应用[J].中国美容整形外科杂志,2007,18(3):169-171.
[12]张建辉,唐嗣泉,杨洪斌.鼻面部邻近皮瓣在外鼻部分缺损修复中的应用[J].中华临床医师杂志(电子版),2013,7(23):329-330.
[13]LUNATSCHEK C,SCHWIPPER V,SCHEITHAUER M.Soft tissue reconstruction of the nose[J].Facial Plast Surg,2011,27:249-257.
[14]TAKEDA A,AKIMOTO M,PARK K.Singlestage reconstruction of a full thickness alar defect using a folded nasolabial flap combined with a redundant skin turnover flap[J].J Craniofac Surg,2014,25:2144-2146.
[15]HAN D H,MANGOBA D C,LEE D Y,et al.Reconstruction of nasal alar defects in Asian patients[J].Arch Facial Plast Surg,2012,14:312-317.
[16]HWANG K,LEE G I,PARK H J.Branches of the facial artery[J].J Craniofac Surg,2015,26:1399-1402.
[17]LOMBARDO G A,TAMBURINO S,TRACIA L,et al.lateral nasal artery perforator flaps:anatomic study and clinical applications[J].Arch Plast Surg,2016,43:77-83.
[2]徐梁,俞哲元,袁捷,等.鼻面沟带蒂皮瓣在鼻部亚单位缺损修复中的应用[J].组织工程与重建外科杂志,2016,12(3):174-176.
[3]邵英,张舵,赵自然,等.侧鼻动脉为蒂的鼻唇沟皮瓣修复鼻缺损[J].中国修复重建外科杂志,2010,24(5):526-527.
[4]岳毅刚,李佩英,秦小云.鼻唇沟任意型皮瓣血供的解剖学基础[J].中国临床解剖学杂志,2002,20(4):259-260.
[5]MAHER I A,LAVIGNE K.Use of the standing cone allows for subunit repair of a large composite cheek and nose defect[J].Dermatol Surg,2014,40:1255-1258.
[6]王炜.整形外科学[M].杭州:浙江科学技术出版社,1999:1045-1045.
[7]宋可新,王友彬,黄渭清,等.鼻部浅表肿物切除后的创面修复[J].中华损伤与修复杂志(电子版),2014,9(1):55-56.
[8]LINDSAY K J,MORTON J D.Flap or graft:The best of both in nasal ala reconstruction[J].J Plast Reconstr Aesthet Surg,2015,68:1352-1357.
[9]AKDAGLI S,LEE M K,MOST S P.Bilobeflap with auricular cartilage graft for nasal alar reconstruction[J].Am J Otolaryngol,2015,36:479-483.
[10]LIN W,QING Y,LIU J,et al.Alar flap combined with free auricular composite flap for the reconstruction of nasal alar defect[J].J Craniofac Surg,2015,26:562-564.
[11]郭澍,韩思源,卢利,等.鼻唇沟皮瓣在鼻唇缺损修复中的应用[J].中国美容整形外科杂志,2007,18(3):169-171.
[12]张建辉,唐嗣泉,杨洪斌.鼻面部邻近皮瓣在外鼻部分缺损修复中的应用[J].中华临床医师杂志(电子版),2013,7(23):329-330.
[13]LUNATSCHEK C,SCHWIPPER V,SCHEITHAUER M.Soft tissue reconstruction of the nose[J].Facial Plast Surg,2011,27:249-257.
[14]TAKEDA A,AKIMOTO M,PARK K.Singlestage reconstruction of a full thickness alar defect using a folded nasolabial flap combined with a redundant skin turnover flap[J].J Craniofac Surg,2014,25:2144-2146.
[15]HAN D H,MANGOBA D C,LEE D Y,et al.Reconstruction of nasal alar defects in Asian patients[J].Arch Facial Plast Surg,2012,14:312-317.
[16]HWANG K,LEE G I,PARK H J.Branches of the facial artery[J].J Craniofac Surg,2015,26:1399-1402.
[17]LOMBARDO G A,TAMBURINO S,TRACIA L,et al.lateral nasal artery perforator flaps:anatomic study and clinical applications[J].Arch Plast Surg,2016,43:77-83.