额部双瓣法+二期耳软骨植入修复鼻洞穿性缺损

Repair of nasal perforation with a combination of bilateral frontal flap and autologous ear cartilage transplantation

目的观察一期双侧额部皮瓣修复鼻皮肤黏膜缺损+二期耳软骨移植术修复鼻洞穿性缺损的效果。方法 5例年龄65~83岁的鼻部基底细胞癌患者,肿物扩大切除后均形成洞穿性缺损,鼻部内侧缺损大小1.5 cm×1.5 cm^3.5 cm×3.5 cm,外部皮肤缺损3.5 cm×3.5 cm^5.5 cm×6.0 cm,一期应用双侧额部皮瓣修复,3例在术后3个月复诊进行二期皮瓣臃肿修补术+耳廓软骨植入鼻翼成型术。结果双侧转移皮瓣均成活,修复的外鼻色泽良好与周边皮肤一致,修复后鼻翼接近正常鼻翼。结论该手术方法适合于各类鼻洞穿性缺损的修复,术后修复的效果及外形均较满意。

Objective To investigate the clinical effect of bilateral frontal flaps for the reconstruction of nasal skin as Stage One Operation and autologous ear cartilage transplantation for the repair of nasal perforation as Stage Two Operation.Methods 5 cases with basal cell carcinoma aging from 65 to 83 years old were enrolled. All cases had perforating defects after extensive neoplasm resection, whose inner size was about 1.5 cm × 1.5 cm- 3.5 cm× 3.5 cm inside while outer size was 3.5 cm × 3.5 cm- 5.5 cm × 6.0 cm. All the cases received bilateral frontal flaps reconstruction in nasal skin as Stage One Operation, and three of them were given flap repair and autologous ear cartilage transplantation as Stage Two Operation 3 months later. Results Bilateral flap transplant all survived with the nasal skin and ala nasi almost close to normal after repair surgery. Conclusion The combined surgery is suitable for all types of surgical repair for nasal perforation, and the effect and the appearance is satisfactory.