Qian Yun-liang, Zhang Yi-xin, Yang Jun, Wang Dan-ru, Zhang Yu-guang
Department of Plastic and Reconstructive Surgery, the Ninth People's Hospital, Shanghai Second Medical University, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2005 Nov;21(6):457-60.
The nose is composed of several delicate subunits, some of which are difficult to reconstruct if they have been injured. The paper presents the microsurgical technique to repair the nasal subunit defects with the free combined preauricular and auricular flap which well match the nasal tissues in texture, contour and color.
The nasal subunit defects were repaired with the combined preauricular and auricular flap which were vascularized by the superficial temporal vascular system. The flap was harvested from the contralateral preauricular and the region of helix crus. The superficial temporal vessels were anastomosed to facial vessels via the vascular grafts harvested from the lateral circumfluent femoral vessels, which were about 10 to 14 cm in length. The helix crus of donor ear was reconstructed with the post-auricular flap.
28 cases were treated, including 3 cases of nasal tip defects, 9 cases of combined nasal alar and sidewall defects, and 16 cases of nasal alar defects. In these cases, the size of the subunit defects varied from 2.5 cm x 1.5 cm to 4 cm x 2.5 cm. 27 cases were successfully repaired with satisfactory results. The contour of reconstructed helix crus in donor site was acceptable. No walking dysfunction of the donor thigh was complained. There is one failed case, and the possible reason is the insufficient blood perfusion to the flaps, which may due to the patient's longtime-smoking status and the hypertension.
The technique of free combined preauricular and auricular flap is ideal for the reconstruction of nasal subunit defects.
鼻子由几个精细的亚单位组成，如果这些亚单位受损，其中一些很难修复。本文介绍了一种显微外科技术，即采用游离耳前和耳廓联合皮瓣修复鼻亚单位缺损，该皮瓣在质地、轮廓和颜色上与鼻组织非常匹配。
采用颞浅血管系统供血的耳前和耳廓联合皮瓣修复鼻亚单位缺损。皮瓣取自对侧耳前和耳轮脚区域。颞浅血管通过取自股外侧旋血管的血管移植物与面血管吻合，血管移植物长度约为10至14厘米。供耳的耳轮脚用耳后皮瓣重建。
共治疗28例，其中鼻尖缺损3例，鼻翼及鼻侧壁联合缺损9例，鼻翼缺损16例。这些病例中，亚单位缺损大小从2.5厘米×1.5厘米到4厘米×2.5厘米不等。27例成功修复，效果满意。供区重建耳轮脚的轮廓可接受。未诉供区大腿行走功能障碍。有1例失败病例，可能原因是皮瓣血运不足，这可能与患者长期吸烟状态及高血压有关。
游离耳前和耳廓联合皮瓣技术是修复鼻亚单位缺损的理想方法。
