基于鼻部美学亚单位鼻翼缺损修复术式的选择

Repair methods of nasal alar defects based on nasal aesthetic subuint

目的参照鼻部美学亚单位的原则，根据鼻翼缺损的大小和毗邻亚单位的缺损，选择鼻翼缺损的修复术式。方法自2011年7月至2013年6月，我们共收治6例鼻翼缺损的患者。其中鼻翼亚单位缺损4例，行耳郭复合组织游离移植；鼻翼合并鼻尖亚单位缺损2例，应用显微外科技术，行逆行颞浅血管供血的耳前皮瓣游离移植，血管蒂与受区邻近的鼻唇沟处角动、静脉吻合。结果本组6例游离组织均成活，随访6～12个月，重建的鼻翼皮肤色泽与周边接近，弹性正常，瘢痕隐蔽。结论大于鼻翼亚单位50％的缺损，用耳郭复合组织游离移植修复；鼻翼合并鼻尖亚单位的缺损，用吻合血管的逆行游离耳前皮瓣修复。

Objective Based on the nasal aesthetic subuint principle, to select reasonable methods for the repair of the nasal alar defects according to the defective size of nasal alar and its adjacent subunit. Methods Retrospective analysis was carried out on 6 cases with nasal alar defects during July 2011 to June 2013, including 4 cases with defects of the alar subunit which were repaired by auricular compsite tissue graft ; the other 2 cases with defects of the alar subunit combined with nasal tip which were repaired with reverse preauricular flap by microsurgieal technique. Results All patients were followed up for 6 to 12 months. The reconstructed alars on 6 eases were all survived with good aesthetic results, like excellent color, normal elasticity and concealed scar. Conclusion The one with more than 50% the alar subunit defect could be repaired with auricular compsite tissue graft; the others with the alar subunit defect combined with subunit defect of the adjacent nasal tip could be repaired with reverse preaurieular flap by mierosurgical technique.