额瓣在修复外鼻大面积缺损中的临床应用

张维天; 张玉君; 吴红敏; 朱华明; 程付伟; 殷善开

doi:10.13201/j.issn.1001-1781.2012.23.005

额瓣在修复外鼻大面积缺损中的临床应用

- 上海交通大学附属第六人民医院耳鼻咽喉科上海交通大学耳鼻咽喉科研究所(上海, 200233)

详细信息

通讯作者: 殷善开,E-mail:yinshankai@china.com

中图分类号: R765.1

收稿日期: 2012-05-09

Reconstruction of large external nose defect with forehead flap

- Department of Otorhinolaryngology, Affiliated No. 6 People's Hospital Shanghai Jiaotong University, Shanghai, 200233, China

More Information

Corresponding author: YIN Shankai, E-mail: yinshankai@china.com

Received Date: 09 May 2012

摘要

摘要: 目的:探讨应用以滑车上动脉以及内眦动脉为蒂的额瓣修复外鼻大面积缺损的方法和疗效。方法:回顾性分析2007-01-2011-06收治的11例应用额瓣修复外鼻大面积缺损患者的临床及随访资料。皮肤恶性肿瘤切除后缺损9例,外伤性缺损2例。皮肤缺损直径均＞3 cm,其中鼻翼全层缺损4例。术前针对高龄、可疑患有外周血管病变患者采用多普勒超声检查滑车上动脉以及内眦动脉血流状况。7例患者修复时采用经面前插入式额瓣修复,后经二期手术断蒂;5例采用岛状额瓣经眉间皮下隧道一期重建鼻缺损;4例鼻翼全层缺损的患者则采用鼻唇沟瓣修复衬里。结果:所有患者缺损均修复成功,组织瓣全部成活,无坏死。1例鼻翼全层缺损患者术后半年随访时鼻孔略狭窄,有轻度鼻塞。患者均随访6个月~2年,肿瘤无复发。结论:以滑车上动脉以及内眦动脉为蒂的额瓣修复是修复外鼻大面积缺损的安全可靠的方法。
- 外鼻 /
- 皮肤癌 /
- 重建外科技术 /
- 额瓣
Abstract: Objective: To discuss the role of forehead flap in large external nasal defect reconstruction.Method: We retrospectively reviewed the clinical and follow-up data of 11 patients with large or full-thickness external nasal defects, which were reconstructed with single-or two-stage interpolated or island forehead flaps from January 2007 to June 2011. All patients were male,defects of 9 cases were resulted from resection of skin malignant tumor and traumatic defect in 2 cases. The average diameter of defects was 3.3 cm(2.5-5.0cm). Four cases had alar full thickness defect. The supratrochlear and angular artery of the elders(＞70 yrs) and patients with suspecious peripheral blood vessel lesions were scanned before the surgery by Doppler ultrasonic. The defects were reconstructed by two-stage interpolated flap in 7 cases; five cases were reconstructed by single-stage island flap technique. A nasolabial flap based on piriform aperture was turned into the nasal cavity to reconstruct the lining.Result: All defects were repaired successfully. All tissue flap survived and the scar was not conspicuous. One patient had nostril stenosis with mild nasal congestion complain at the 6th postoperative month.Conclusion: The forehead flap, interpolated or island, can be used safely and effectively to repair the large external nasal defect in experienced hands.
- external nose /
- skin cancer /
- reconstructive surgical procedures /
- frontal flaps

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