双叶瓣在修复外鼻肿块切除术后缺损的临床应用

Reconstruction of nasal defect with bilobed flap

目的 探讨评估应用双叶瓣修复外鼻软组织缺损的外观和功能疗效。方法 所有患者鼻端和鼻翼新生物采用Mohs显微外科切除,所有标本经冰冻切片诊断病变性质和切缘的安全边界,鼻端和鼻翼的缺损采用双叶瓣,覆盖关闭缺损的创面和皮瓣供区。结果 15例鼻端和鼻翼肿瘤患者中良性病变4例,恶性病变11例,其中基底细胞癌9例,鳞癌2例,经双叶瓣修复后,所有患者切口1期愈合,经过3~24个月随访,除1例鼻翼缘向上退缩,其他患者均得到较好的修复,无明显牵拉扭曲,外观自然。结论 双叶瓣是修复鼻端和鼻翼缺损的简单有效的方法,可使鼻外观及功能上得到较好的修复效果。

Objective To evaluate the esthetic and functional reconstructive effect of bilobed flap for nasal defect. Methods 15 patients received Mohs micrographic surgery （MMS） and their nasal defects were reconstructed with bilobed flap. Results Postoperative pathologic examination revealed benign in 4 cases and malignant in 11 （ basal cell carcinoma in 9 and squamous cell carcinoma in 2 ）. Being followed up for 3 to 24 months postoperatively, 14 cases obtained acceptable esthetic and functional outcome while retraction of nasal ala edge occurred in one. Conclusion With advantages of being simple to operate and acceptable esthetic and functional outcome, bilobed flap is effective for reconstruction of nasal defect.