额部皮肤扩张联合耳廓软骨修复鼻翼全层缺损的临床效果

Forehead skin expansion combine with auricular cartilage for repairing nose alar full-thickness defects

目的探讨应用额部扩张皮瓣联合耳廓软骨修复鼻翼全层缺损的临床疗效。方法对2010年8月至2016年8月收治的36例鼻翼全层缺损，范围在1．5cm×1．2cm以上的患者，在额部埋置容量50～80ml扩张器，注水超量扩张获得多余皮肤。缺损处鼻背皮肤翻转做衬里，切取患侧耳廓软骨做支架，扩张后的额部皮瓣带蒂转移覆盖于软骨表面，供区皮肤直接拉拢缝合。2个月后行鼻根部皮瓣断蒂修整术。结果术后随访3～18个月，全部皮瓣成活，成功修复鼻翼缺损，部分病例做再次修整。所有修复病例鼻翼色泽、厚度、鼻孔大小外形与对侧基本对称。供瓣区切口线性愈合，留有线性瘢痕。结论额部扩张法能获得较大面积的皮瓣，足够修复大面积鼻翼全层缺损。术后供区瘢痕不明显。

Objective To discuss clinical curative effects of using Forehead skin expansion combine with auricular cartilage for repairing nose alar full-thickness defects. Methods From August 2010 to August 2010, 36 patients with nose Mar full-thickness defects in the second affiliated hospital of kunmin medical university, The defect range exceed 1.5 cm× 1.2 cm. 50-80 ml expander was implan- ted in forehead and injected saline water to expand in order to acquire extra skin .We Turn around the skin of defect as the lining of nose, harvest ipsilateral auricular cartilage for nose ala framework, Expanded forehead pedicle flap was transferred to cover framework. The donor area was sutured directly. The pedicle of flap was cut and trimmed after 2 months. Results Follow-up time of 3-18 months after the operation, All flaps are survive, nose alar defects are repaired successfully. Some cases were performed second surgery, postoperative, nose alar color, thickness, nostril size and shape the same with the contralateral side. Donor site healed with linear sear. Conclusions This method could be easy to obtain excess skin, for repairing large sides nose alar full-thickness defect. Frontal scar is not obvious, It is a practical.