局部组织瓣整复鼻缺损的临床经验

Reconstruction to Nasal Defect with Local Tissue Flaps

目的:探索修复鼻翼缺损简单易行、形态效果佳的治疗方法。方法:自1995年以来共收治30例鼻缺损患者,其中额部中央皮瓣3例,以一侧滑车上血管蒂经鼻根皮下隧道穿行到鼻部缺损区;鼻唇沟组织瓣者17例19侧,均设计蒂在上的组织瓣;耳廓全厚三明治式游离瓣10例11侧。结果:额部中央皮瓣3例,鼻唇沟组织瓣17例全部成活;耳廓全厚三明治式游离瓣10例,其中1例首次移植坏死,第2次手术成功。结论:扩张增容后的中央额瓣是全鼻缺损再造的首选治疗方案;整复鼻翼、鼻尖缺损,单侧鼻唇沟皮瓣长度在4～5cm,宽度在1.2～1.5cm为佳。耳廓全厚三明治式游离瓣,宽度在1.8cm以内较安全。

Objective： To conclude the experience of local tissue flaps in nasal reconstruction. Methods： 30 cases with nasal defect have been treated in our department since 1995. The forehead central skin flap was used for 3 cases, nasolabial tissue flap was used for 17 cases （19 sides） and the auricular composite tissue flap was used for 10 eases（ll sides）. Results： All the forehead central skin flaps and nasolabial tissue flaps survived.1 case treated with auricular composite tissue flap was necrosed, but successed at 2nd operation. Conclusion： The expanded forehead skin flap is the most effective method to reconstruct the nasal defect. Suitable unilateral nasolabial tissue flap is the flap with length of 4- 5 cm, and width of 1.2-1.5 era. Auricular composite tissue flap small than 1.8 cm is safety in clinic.