应用改进的额部扩张皮瓣行全鼻再造术

Nasal reconstruction with the modified expanded forehead skin flap

目的探讨应用改进设计的额部扩张皮瓣行全鼻再造术的效果。方法将前额主要供血支部分结扎阻断,保留选用的轴型血管蒂,强化皮瓣扩张的延迟效应,除设计以额正中皮瓣做全鼻再造外,还选用额上区横向扩张皮瓣,其供区缺损施以同侧或对侧扩张皮瓣推进修复,直接缝合。共已应用11例。结果11块额部扩张皮瓣转移后完全存活,随访6个月～8年4个月,再造鼻功能形态恢复满意,供区瘢痕不明显。结论强化额部扩张皮瓣血供或选用额上区横向皮瓣都是鼻再造的有效方法。

Objective To investigate the effect of the modified expanded forehead skin flap in nasal reconstruction. Methods According to flap design, the frontal arteries that were not selected as the pedicle were ligated in order to enhance expansion and delay effects. Besides the middle forehead skin flap for nasal reconstruction, the expanded transversal forehead flap was employed with its donor site sutured directly, resulting in inconspicuous scar. This method was used for 11 cases of nasal reconstruction. Results All the flaps survived. Postoperative follow up for 6 months to 8 years and 4 months showed satisfactory results with good appearance and function. Conclusions The method of modulating the blood supply to the flap and selecting the upper area of the forehead for the flap is an effective modification for nasal reconstruction. ;