颞浅动静脉岛状皮瓣修复鼻翼缺损

Repair of Nosewing by Microsurgical Transfer of Island Flap with Superficial Temporal Vessels

目的探索应用显微外科技术切取和分离颞浅动静脉筋膜岛状皮瓣,为完整保留细长血管蒂的血供系统尤其是静脉系统提供技术方法。材料和方法在颞浅动静脉走行分离、伴行不密切的情况下,待完整剥离头皮后采用显微外科技术对皮瓣细长的颞浅动静脉筋膜蒂进行仔细游离和修整,保留颞浅动脉和细密的颞浅静脉分支,建立相对完整的血管网络。结果血管网保留完整,移植皮瓣早期肿胀,其后很快恢复正常的颜色和质地,修复鼻裂畸形外观满意,形态丰满,鼻翼亚解剖结构存在,并有良好的支撑力度。结论颞浅动静脉岛状皮瓣局部转移是修复鼻部小面积缺损的较好方法之一,但是在颞浅动静脉伴行不良的情况下,往往会导致静脉回流不佳或移植皮瓣过于臃肿影响外观。利用显微外科技术进行细致的镜下分离可以很好地保留颞浅动脉和颞浅静脉分支,从而建立相对完整的血管网络,保证顺畅的皮瓣供血和回流,获得良好的修复效果。

Objective To explore a microsurgical approach to repair nosewing defect with island flap that possesses a relatively intact vessel pedicle containing both superficial temporal arteries and veins. Materials and Methods Remove the scalp completely, isolate and trim the long and thin fascial pedicle with superficial temporal vessels and transfer the flap to repair the nosewing defect. Results With nearly complete vascular network, the flap swelled early after transfer, but soon regained normal color and texture. The nosewing showed good appearance with proper sub-anatomical structure and support strength. Conclusion Localized transfer of island flap with superficial temporal vessels can be used in small nose defect. Yet it may result in overstuffed outlook due to impaired vessel pedicle. With the microsurgical technique, we can reserve a relatively intact vascular network system, and thus ensure good blood supply and circulation, which will lead good repair results.