细长皮管修复鼻小柱缺损

REPAIR OF NASAL COLUMELLA DEFECT WITH LONG SLENDER TUBED FLAP

目的 总结通过留“桥”技术形成的细长皮管在鼻小柱再造中的应用。方法 196 8年 3月～ 1998年 8月 ,利用留“桥”技术形成细长皮管 ,分次转移 ,修复复杂鼻小柱缺损共 18例。采用上臂内侧纵行皮管 13例 ,颈部锁骨上横行皮管 5例 ,设计皮管宽度 2 .0～ 2 .5 cm,长度 11～ 15 cm,皮管中段 3～ 7cm于其一侧留“桥”。结果18例皮管均成活 ,无并发症 ,随访 3～ 6 0个月 ,再造鼻小柱外形、质地、色泽、抗损伤能力均良好。结论 为保证细长皮管的血运 ,皮管中段需留“桥”,二期断“桥”。此皮管能提供外形精致、相对丰富的组织 ,在修复鼻小柱缺损 ,特别是合并鼻尖、鼻中隔、鼻翼部分缺损 ,或伴有口鼻周围软组织缺损时 ,可修复多处畸形 ,效果良好。缺点是疗程稍长。

Objective To introduce the clinical application of long slender tubed flap constructed with “bridge” technique in the repair of nasal columella defect. Methods From March 1968 to August 1998, 18 cases with complicated nasal columella defects were repaired with long slender tubed flaps. Among the 18 tubed flaps, 13 cases were designed on the medial side of the upper arm and 5 cases on the longer cervical region paralleling the clavicle. The tubed flaps were 2.0 to 2.5 cm wide and 11 to 15 cm long. The length of the 'bridge' was 3 to 7 cm. Results\ No flap necrosis or other complications occurred. Postoperative follow-up was 3 to 60 months. The reconstructed columellae showed satisfactory contour, good texture and color, and satisfactory resistance to injury. Conclusion\ By using the “bridge” technique, tubed flap can be made long and slender enough to provide relatively abundant tissue with adequate circulation and delicate contour. Combined with strict case selection, long slender tubed flaps can bring excellent functional and cosmetic outcomes in the repair of nasal columella defects including those with partial defect of the nasal tip, ala ,septum, or defect of adjacent soft tissue. However, this method is relatively time-consuming.