额部带蒂扩张皮瓣转移修复全鼻缺损的临床观察

Expand pedicle forehead flap in the repair of whole nasal defect

目的:探讨额部扩张皮瓣带蒂转移修复全鼻缺损的方法。方法:2010-06-2016-03期间应用额部带蒂扩张皮瓣转移修复全鼻缺损11例,于额部帽状腱膜下植入300ml皮肤软组织扩张器,注水扩张完毕后,设计带蒂扩张皮瓣内含滑车上动静脉三叶状皮瓣,取右季肋部第7、8肋软骨,雕刻成"L"形自体肋软骨鼻支架,植入鼻衬里和皮瓣之间再造全鼻,半年后断蒂修整再造鼻。结果:额部带蒂扩张皮瓣与移植的自体肋软骨鼻支架全部成活,再造鼻形状逼真,鼻腔通气功能良好,随访1~5年,再造鼻颜色正常,血运佳,供皮区额部仅有一线形瘢痕。结论:额部带蒂扩张皮瓣转移修复全鼻缺损,再造鼻形状良好,患者满意,是目前全鼻再造的一种较好的手术方法。

Objective：To observed the application of expanded pedicle forehead flap in nasal defect.Method：Totally 11 whole nasal defect cases in our department from June 2010 to March 2016 were treated with the expanded pedicle forehead flap.Regular follow-up was performed after operation to observe the survival condition of flaps,shape,color,texture and scar in donor site after nasal repair.Result：The expanded pedicle forehead flap and transplantation of autologous costal cartilage nasal stents were all survived,the reconstruction nasal shape was satisfied.After 1-5 years follow up,the repair using expanded forehead flap had a good color with enough blood supply,and the nasal ventilation function is well.There was only one linear scar leaved in donor site.Conclusion：Application of the expanded pedicle forehead flap is a good mothed for the treatment of whole nasal defect.