Nasal defects are facial defects caused by trauma,tumors,or congenital diseases that seriously damage a patient’s physical and mental health.Nasal defects,from skin defects to total nasal defects,require surgical rep...Nasal defects are facial defects caused by trauma,tumors,or congenital diseases that seriously damage a patient’s physical and mental health.Nasal defects,from skin defects to total nasal defects,require surgical repair and reconstruction to restore the appearance and function of the nose,which have always been challenges for rhinoplasty.The development of digital technology has increased the possibility of nasal reconstruction.Digital technology is involved in the preoperative,intraoperative,and postoperative stages of nasal construction and is of great significance in improving the effect of this surgery.This article reviews the application of major digital technologies,including three-dimensional(3D)imaging technology,computer-assisted surgical navigation,and 3D printing,in nasal reconstruction and discusses the shortcomings of the current application of digital technology.展开更多
Due to the complex three-dimensional structure of the nose,the repair of the nasal defect requires reconstruction of three different layers:skin envelope,osteocartilaginous framework and nasal lining.Before nasal reco...Due to the complex three-dimensional structure of the nose,the repair of the nasal defect requires reconstruction of three different layers:skin envelope,osteocartilaginous framework and nasal lining.Before nasal reconstruction can be accomplished,the nose must rest on a stable platform to avoid late nasal obstructions,and septal deviations resulting from scar contraction.We present three cases of nasal reconstruction using a forehead flap in which we performed a preliminary stage to increase reliability of outcomes.展开更多
Objective To introduce a method for total nasal defect reconstruction with a double forehead expanded flap.Case presentation A 55-year-old man underwent three-stage total nasal reconstruction for a complete nasal defe...Objective To introduce a method for total nasal defect reconstruction with a double forehead expanded flap.Case presentation A 55-year-old man underwent three-stage total nasal reconstruction for a complete nasal defect due to electrical injury.The skin expander was implanted during the 1st stage.Total nasal reconstruction was performed with double expanded forehead flap transfer during the 2nd stage.The unilateral forehead flap was used for lining and the contralateral forehead flap,together with the autologous cartilage and titanium mesh framework,were used for skin replacement.The forehead donor defect was covered with a skin graft.Pedicle division and inset were performed in the 3rd stage.Results There was no flap loss,infection,hematoma,rhinostenosis,or implant exposure over the 2-year follow-up,and satisfactory aesthetic results were achieved.Conclusion The double forehead expanded flap method is useful for the reconstruction of large composite nasal defects in patients who are not suitable for nasolabial flaps and those who may not tolerate free tissue transfer.The operation has fewer complications and is uncomplicated.展开更多
Nasal defects can be reconstructed with a nasolabial perforator flap,resulting in good aesthetic outcomes based on the facial subunit principle,owing to the combined advantages of the traditional nasolabial flap and t...Nasal defects can be reconstructed with a nasolabial perforator flap,resulting in good aesthetic outcomes based on the facial subunit principle,owing to the combined advantages of the traditional nasolabial flap and the perforator flap.However,the localization of perforators makes the clinical application of a nasolabial perforator flap difficult.This review aims to provide a comprehensive summary of the nasolabial perforator flap from anatomical,methodological,and clinical application aspects,intending to provide plastic surgeons with a reference on conducting nasal reconstruction with a nasolabial perforator flap.展开更多
Rhinoplasty and septal reconstruction often require the use of cartilage grafts.Complete nasal septal reconstruction may be required in very specific situations like difficult secondary septoplasty or severely deforme...Rhinoplasty and septal reconstruction often require the use of cartilage grafts.Complete nasal septal reconstruction may be required in very specific situations like difficult secondary septoplasty or severely deformed post traumatic noses.Usually in these cases the septal cartilage or bone is insufficient for septal reconstruction.The authors hereby describe a new technique of complete septal reconstruction by using the 7th rib(costal)cartilage combined with author’s ingenious technique to prevent warping.展开更多
Aim:The correction of nasal tip defects presents many challenges.Zitelli’s bilobed flap has been widely used for such repairing defects,but may be complicated by interrupted scars on the nasal dorsum.Our study evalua...Aim:The correction of nasal tip defects presents many challenges.Zitelli’s bilobed flap has been widely used for such repairing defects,but may be complicated by interrupted scars on the nasal dorsum.Our study evaluates the design principles,results,and advantages of a modified bilobed flap for repairing nasal tip defects.Methods:The primary lobe was located between the defect and the cheek,and the second lobe was located in the cheek.The width of the primary lobe was equal to that of the primary defect.The length of the primary lobe was 10%longer than the distance of the distal defect edge to the pivot point of the flap.The length of the second lobe was 30%longer than the distance of the distal defect edge to the pivot point of the flap.The width of the second lobe was 90-100%of that of the primary lobe.The ability to close the defect under minimal tension,the cosmetic appearance,and any complications were evaluated.Results:This technique was performed in 34 cases;defect size ranged from 0.8 cm×0.9 cm to 1.2 cm×1.8 cm.All defects were closed under minimal wound tension,all scars were inconspicuous,no obvious complications occurred,and the aesthetic outcomes were considered favorable.Conclusion:The modified bilobed flap can provide satisfying outcomes with lower morbidity and inconspicuous scarring.It is simple and suitable for repairing small-to medium-sized defects in the nasal tip.展开更多
Skin grafts may be used for coverage of facial defects in situations in which alternative methods of reconstruction,such as local flaps,are not an option.They may also be beneficial for patients who wish to avoid or w...Skin grafts may be used for coverage of facial defects in situations in which alternative methods of reconstruction,such as local flaps,are not an option.They may also be beneficial for patients who wish to avoid or who are not good candidates for more complex reconstruction.Full-thickness skin grafts often have a better color and texture match to adjacent skin when compared to split-thickness grafts;however,split-thickness grafts have lower metabolic demand and increased survival rate.Composite grafts may be very useful in the repair of defects with unique contour and support requirements,such as the nasal ala and eyelid.With all grafts,thoughtful planning and sound surgical technique are critical in achieving the best possible functional and aesthetic result.展开更多
基金supported by the Clinical Key Project of the Peking University Third Hospital(grant no.BYSYFY2021005).
文摘Nasal defects are facial defects caused by trauma,tumors,or congenital diseases that seriously damage a patient’s physical and mental health.Nasal defects,from skin defects to total nasal defects,require surgical repair and reconstruction to restore the appearance and function of the nose,which have always been challenges for rhinoplasty.The development of digital technology has increased the possibility of nasal reconstruction.Digital technology is involved in the preoperative,intraoperative,and postoperative stages of nasal construction and is of great significance in improving the effect of this surgery.This article reviews the application of major digital technologies,including three-dimensional(3D)imaging technology,computer-assisted surgical navigation,and 3D printing,in nasal reconstruction and discusses the shortcomings of the current application of digital technology.
文摘Due to the complex three-dimensional structure of the nose,the repair of the nasal defect requires reconstruction of three different layers:skin envelope,osteocartilaginous framework and nasal lining.Before nasal reconstruction can be accomplished,the nose must rest on a stable platform to avoid late nasal obstructions,and septal deviations resulting from scar contraction.We present three cases of nasal reconstruction using a forehead flap in which we performed a preliminary stage to increase reliability of outcomes.
基金This study was supported by project grants(Y20008)from the postgraduate educational reform of Fujian Medical University.
文摘Objective To introduce a method for total nasal defect reconstruction with a double forehead expanded flap.Case presentation A 55-year-old man underwent three-stage total nasal reconstruction for a complete nasal defect due to electrical injury.The skin expander was implanted during the 1st stage.Total nasal reconstruction was performed with double expanded forehead flap transfer during the 2nd stage.The unilateral forehead flap was used for lining and the contralateral forehead flap,together with the autologous cartilage and titanium mesh framework,were used for skin replacement.The forehead donor defect was covered with a skin graft.Pedicle division and inset were performed in the 3rd stage.Results There was no flap loss,infection,hematoma,rhinostenosis,or implant exposure over the 2-year follow-up,and satisfactory aesthetic results were achieved.Conclusion The double forehead expanded flap method is useful for the reconstruction of large composite nasal defects in patients who are not suitable for nasolabial flaps and those who may not tolerate free tissue transfer.The operation has fewer complications and is uncomplicated.
基金supported by the Key Clinical Projects of Peking University Third Hospital (grant no. BYSYFY2021005)
文摘Nasal defects can be reconstructed with a nasolabial perforator flap,resulting in good aesthetic outcomes based on the facial subunit principle,owing to the combined advantages of the traditional nasolabial flap and the perforator flap.However,the localization of perforators makes the clinical application of a nasolabial perforator flap difficult.This review aims to provide a comprehensive summary of the nasolabial perforator flap from anatomical,methodological,and clinical application aspects,intending to provide plastic surgeons with a reference on conducting nasal reconstruction with a nasolabial perforator flap.
文摘Rhinoplasty and septal reconstruction often require the use of cartilage grafts.Complete nasal septal reconstruction may be required in very specific situations like difficult secondary septoplasty or severely deformed post traumatic noses.Usually in these cases the septal cartilage or bone is insufficient for septal reconstruction.The authors hereby describe a new technique of complete septal reconstruction by using the 7th rib(costal)cartilage combined with author’s ingenious technique to prevent warping.
文摘Aim:The correction of nasal tip defects presents many challenges.Zitelli’s bilobed flap has been widely used for such repairing defects,but may be complicated by interrupted scars on the nasal dorsum.Our study evaluates the design principles,results,and advantages of a modified bilobed flap for repairing nasal tip defects.Methods:The primary lobe was located between the defect and the cheek,and the second lobe was located in the cheek.The width of the primary lobe was equal to that of the primary defect.The length of the primary lobe was 10%longer than the distance of the distal defect edge to the pivot point of the flap.The length of the second lobe was 30%longer than the distance of the distal defect edge to the pivot point of the flap.The width of the second lobe was 90-100%of that of the primary lobe.The ability to close the defect under minimal tension,the cosmetic appearance,and any complications were evaluated.Results:This technique was performed in 34 cases;defect size ranged from 0.8 cm×0.9 cm to 1.2 cm×1.8 cm.All defects were closed under minimal wound tension,all scars were inconspicuous,no obvious complications occurred,and the aesthetic outcomes were considered favorable.Conclusion:The modified bilobed flap can provide satisfying outcomes with lower morbidity and inconspicuous scarring.It is simple and suitable for repairing small-to medium-sized defects in the nasal tip.
文摘Skin grafts may be used for coverage of facial defects in situations in which alternative methods of reconstruction,such as local flaps,are not an option.They may also be beneficial for patients who wish to avoid or who are not good candidates for more complex reconstruction.Full-thickness skin grafts often have a better color and texture match to adjacent skin when compared to split-thickness grafts;however,split-thickness grafts have lower metabolic demand and increased survival rate.Composite grafts may be very useful in the repair of defects with unique contour and support requirements,such as the nasal ala and eyelid.With all grafts,thoughtful planning and sound surgical technique are critical in achieving the best possible functional and aesthetic result.
