内眦动脉为蒂的鼻唇沟皮瓣在鼻多个亚单位缺损修复中的应用
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摘要
目的探讨内眦动脉为蒂的鼻唇沟皮瓣修复鼻多个亚单位缺损的临床效果。方法对19例鼻亚单位缺损患者均采用内眦动脉为蒂的鼻唇沟皮瓣修复,创面面积为1.1 cm×1.5 cm~2.5 cm×4.0 cm。根据缺损面积,在鼻唇沟处设计包括内眦动脉走行在内的蒂在上方的皮瓣,沿设计线切开至浅筋膜,于肌层掀起皮瓣;在无张力的情况下旋转皮瓣至创面,缝合创口。结果本组共19例患者,术后随访6~24个月,皮瓣全部成活,且全部完成一期修复手术,外形良好,无瘢痕增生。结论采用内眦动脉为蒂的鼻唇沟皮瓣,可以利用面颊部与鼻唇部的天然皱褶,很好地隐藏术后瘢痕,且具有血供丰富的特点,是一种可用于鼻多个亚单位修复的良好方法。
Objective To investigate the therapeutic effect of angular artery pedicle nasolabial fold flap in the repair of multiple nasal subunit defects.Methods The nasal subunit defects of 19 patients were repaired by angular artery pedicle nasolabial fold flaps.The defect area was from 1.1 cm ~ 1.5 cm to 2.5 cm ~ 4.0 cm.Flaps were designed based on the defect areas,including the angular artery in the nasolabial fold.The flaps were cut to the superficial fascia along the design lines,and then elevated in the muscular layer.The flaps were rotated to the wounds without tension.Finally,the defect areas were sutured.Results All patients were followed up for 6 to 24 months.The nasal defects healed primarily.All the angular artery pedicle nasolabial fold flaps survived and achieved good appearance without hypertrophic scar.Conclusion The nasolabial fold flap pedicled with the internal carotid artery can make use of the natural folds of the cheek and nasolabial region.It can hide postoperative scars through its natural crease and own abundant blood supply.It is an ideal method to repair the multiple nasal subunit defects.
Objective To investigate the therapeutic effect of angular artery pedicle nasolabial fold flap in the repair of multiple nasal subunit defects.Methods The nasal subunit defects of 19 patients were repaired by angular artery pedicle nasolabial fold flaps.The defect area was from 1.1 cm ~ 1.5 cm to 2.5 cm ~ 4.0 cm.Flaps were designed based on the defect areas,including the angular artery in the nasolabial fold.The flaps were cut to the superficial fascia along the design lines,and then elevated in the muscular layer.The flaps were rotated to the wounds without tension.Finally,the defect areas were sutured.Results All patients were followed up for 6 to 24 months.The nasal defects healed primarily.All the angular artery pedicle nasolabial fold flaps survived and achieved good appearance without hypertrophic scar.Conclusion The nasolabial fold flap pedicled with the internal carotid artery can make use of the natural folds of the cheek and nasolabial region.It can hide postoperative scars through its natural crease and own abundant blood supply.It is an ideal method to repair the multiple nasal subunit defects.
引文
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[8]曹宁,林广民,郑美莲,等.鼻唇沟旋转皮瓣在上外侧唇缺损亚单位修复中的应用[J].交通医学,2016,3(2):184-185,187.
[9]Tan NC,Hsieh CH,Riva FMG,et al.The nasolabial flap as a one-stage procedure for reconstruction of intermediate-to-large lip defects with functional and aesthetic assessments[J].J Plast Reconstr Aesthet Surg,2013,66(3):352-357.
[10]胡小华,黄桂林,张霓霓,等.鼻唇沟岛状皮瓣在口底组织缺损修复重建中的应用[J].中国修复重建外科杂志,2014,28(6):710-713.
[2]郑厚兵,王彪,黄循镭,等.应用鼻唇沟皮下组织蒂岛状皮瓣修复鼻部皮肤肿瘤切除后刨面[J].中国美容医学,2015,24(1):15-17.
[3]毕宏达,邢新,李军辉.鼻唇-鼻翼沟在鼻唇沟皮瓣修复鼻下部软组织缺损中的应用[J].中国美容整形外科杂志,2013,24(8):469-471.
[4]Ruiz-Moya A,Lagares-Borrego A,Infante-Cossio P.PropeUer facial artery perforator flap as first reconstructive option for nasolabial and perinasal complex defects[J].J Plast Reconstr Aesthet Surg,2015,68(4):457-463.
[5]马春晓,刘媛媛,任珊珊,等.成人头面部模型标本:内眦动脉的定位观测及临床意义[J].中国组织工程研究,2015,19(18):2906-2910.
[6]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.
[7]许瑾,武朱明,余勇,等.鼻唇沟皮瓣在修复面中部皮肤肿瘤术后缺损中的应用[J].中华医学美学美容杂志,2015,21(6):328-330.
[8]曹宁,林广民,郑美莲,等.鼻唇沟旋转皮瓣在上外侧唇缺损亚单位修复中的应用[J].交通医学,2016,3(2):184-185,187.
[9]Tan NC,Hsieh CH,Riva FMG,et al.The nasolabial flap as a one-stage procedure for reconstruction of intermediate-to-large lip defects with functional and aesthetic assessments[J].J Plast Reconstr Aesthet Surg,2013,66(3):352-357.
[10]胡小华,黄桂林,张霓霓,等.鼻唇沟岛状皮瓣在口底组织缺损修复重建中的应用[J].中国修复重建外科杂志,2014,28(6):710-713.