鼻翼旋转皮瓣修复严重鼻翼内陷

Correction of severe alar retraction with alar rotation flap

目的 探讨鼻翼旋转皮瓣修复严重鼻翼内陷的临床效果.方法 首先利用自体肋软骨塑造鼻尖和鼻梁,再以肋软骨补片加长加厚鼻翼凹陷患侧鼻翼软骨,最后按设计采用鼻翼皮肤旋转皮瓣重建患侧鼻翼.结果 2011年5月至2013年11月于临床应用14例,所有患者鼻翼内陷均有改善,皮瓣外观良好,切口愈合良好,瘢痕不明显,鼻翼大小无显著性变化,未出现鼻阻塞等并发症.术后随访6 ～ 30个月,平均11个月,仅1例（单侧）瘢痕形成,其余患者对手术效果表示满意.结论 用鼻翼旋转皮瓣修复鼻翼内陷是一种有效的方法,切口隐蔽,符合鼻整形美学原则.

Objective To investigate the therapeutic effect of alar rotation flap for severe alar retraction.Methods Patients with severely retracted alar underwent ala reconstruction using alar rotation flaps and autogenous cartilage batten grafts.First,costal cartilage was used to reshape the nasal tip and nasal dorsum.Then cartilage patch was used to extend and thicken the retracted alar.Then the alar rotation flap was transferred to correct retracted alar.Results Fourteen patients with severe alar retraction underwent alar reconstruction with alar rotation flap and alar batten grafts.The alar retraction was corrected in all cases,with improvements functionally and aesthetically.No recurrence of alar retraction was noted.The incision healed with acceptable cosmetic results,with obvious scar in only one patient （one side）.Conclusions The alar rotation flap is an effective and reliable surgical option to correct severe alar retraction.Scar can be kept inconspicuous by precise placement of the incision within the junction of the ala and the nasal dorsum,following principles of the aesthetic nasal subunits.