扩大的耳郭复合组织瓣游离移植修复鼻翼缺损

Repairing alae nasi defects with extensive auricle combination tissues

目的探讨应用扩大的耳郭复合组织瓣游离移植修复较大面积鼻翼缺损的手术方法及适应证。方法根据患者鼻翼缺损的范围,采用扩大耳郭复合组织瓣游离移植进行修复。术中彻底松解瘢痕组织,制作血运良好的受区,将耳郭复合组织瓣楔形植入,打包加压固定,术后2周拆线。结果本组患者共32例,成功29例。修复最大的缺损面积为2.2cm×1.8cm,最小面积为1.5cm×1.5cm。随访患者3～6个月,其中7例患者移植耳郭瓣表皮部分脱落,8例患者的移植耳郭瓣均有不同程度地收缩。部分患者移植的耳郭体积缩小约10%,鼻翼大小及外观形态满意。结论通过精细的创面准备、移植固定和打包加压技术,对鼻翼缺损大于1.5cm×1.5cm,选用扩大的耳郭复合组织瓣游离移植修复,是较理想的术式选择。

Objective To discuss the feasibility and operation technique of repairing alae nasi defects with extensive auricle combination tissues. Methods We repair those patients who suffered from alae nazi defects with extensive auricle combination tissues. After excise scars completely and make favorable receipt area, the extensive auricle combination tissues were inserted into the defects with package fixed compactly. The sutures were removed after two weeks. Results 29 patients succeeded of the 32 patients. The maximum defect area was 2.2 cm × 1.8 cm and minimum was 1.5 cm × 1.5 cm. Follow - up visit showed that 7 of the patients＇transplantation auricles had parts of the epidermal lost, and 8 of them showed different degree of volume reduction. The patients were satisfied with the size, figure and color of the new alae. Conclusion By elaborate debridement, transplantation fixation and compression package technique, we can repair alae nasi defects which are larger than 1.5 cm × 1.5 cm with extensive auricle combination tissues transplatation.