鼻缺损修复术中衬里组织的修复

Repair of Nasal Lining in Rhinoplasty

目的探讨鼻缺损修复术中衬里组织的修复方法。方法自2003年1月至2012年10月,根据鼻缺损的情况,对195例各类鼻缺损患者采用局部组织翻转皮瓣、外被皮瓣远端折叠、双瓣法、预制皮瓣等方法来修复衬里,并观察术后效果。结果所有方法衬里皮瓣均成活良好。随访6个月至5年,局部组织翻转皮瓣法最大的并发症是皮瓣挛缩导致的鼻孔狭窄、通气不良,其他方法未见明显并发症。结论在鼻缺损的衬里修复中,需要正确评估鼻部缺损范围、程度,以及周围可利用的残留组织量,选择合适的衬里修复方法,以获得良好的手术效果。

Objective To investigate the optimal methods for the repair of nasal lining in rhinoplasty.Methods From January 2003 to October 2012,195 cases with nasal defects were received rhinoplasty.Regard of the location and size of nasal lining defects,turnover flaps,folded flaps,bi-flaps or prefabricated flaps were used for lining repair.And the efficacy was assessed.Results All the lining flaps were healed by first intention in all approaches.All the patients were followed up for 6 months to 5 years.The airway obstruction were observed in some patients using turnover flaps.No complications were observed in other approaches.Conclusion It is important to evaluate the exact size,level of the defects and the volumes of the surrounding tissues before repairing the lining.Choosing the adequate operation approach can provide good aesthetic and functional results.