额部皮瓣和上臂皮瓣移植修复鼻缺损

Expanded forehead flap or pedicle medial upper arm flap in the repair of nasal defect

目的:观察额部扩张皮瓣和上臂带蒂皮瓣在鼻缺损修复中的应用效果。方法:选择1990-09/2005-09中南大学湘雅医院整形烧伤整形外科收治的鼻缺损患者24例,均知情同意。采用额部扩张皮瓣修复12例,主要为全鼻缺损和鼻大部分缺损;上臂带蒂皮瓣修复12例,主要为鼻下段鼻翼、鼻小柱缺损,其中一期皮管成形同时转移修复较小范围鼻下段鼻翼、鼻小柱缺损4例。术后定期随访,观察皮瓣成活情况、鼻修复后外形、鼻部皮肤颜色与质地及供区瘢痕情况。结果:鼻缺损患者24例全部进入结果分析,无脱落。随访3个月至两年,其中3-6个月8例,6个月至1年10例,1-2年6例。皮瓣全部成活,修复效果基本满意。额部扩张皮瓣修复者鼻部质地、颜色优于上臂带蒂皮瓣,上臂带蒂皮瓣修复者供区瘢痕较隐蔽。结论:额部扩张皮瓣和上臂带蒂皮瓣对鼻缺损患者的修复效果基本满意。

AIM：To observe the application of expanded forehead flap or pedicle medial upper arm flap in nasal defect. METHODS： Totally 24 nasal defect cases in Department of Bums and Plastic Surgery, Xiangya Hospital, Central South University from September 1990 to September 2005 were enrolled. They all knew the experiment and agreed. Totally 12 cases were treated with expanded forehead flap, mainly whole nasal defect or bulk nasal defect. Totally 12 cases were treated with pedicle medial upper arm flap, mainly lower nasal wing defect or defect of coloumna nasi. Of them, tubed flap formed in stage 1 was transfused to repair lower nasal wing or defect of coloumna nasi in 4 cases. Regular follow-up was performed after operation to observe the survival condition of flaps, shape, color, texture and scar in donor site after nasal repair. RESULTS： A total of 24 patients with nasal defect were involved in the result analysis, no drop-out. Follow-up was conducted from 3 months to 2 years. There were 8 cases from 3 to 6 months, 10 cases from 6 months to 1 year and 6 cases from 1 to 2 years. All flaps survived. The effect of reconstruction and repair was satisfied. The repair using expanded forehead flap had a good color and textural match, and the scars in donor site were covered of pedicle medial upper arm flap. CONLUSION： Nasal reconstruction with expanded forehead flap and pedicle medial upper arm flap is satisfactory.