Cervelli Valerio, Bottini D J, Gentile Pietro
Division and Department of Plastic and Reconstructive Surgery, University of Tor Vergata Rome, Italy.
J Craniofac Surg. 2007 Nov;18(6):1380-4. doi: 10.1097/scs.0b013e31814fb6e8.
Defects of the nasal tip present complex problems in terms of reconstruction, since they involve an important region both from functional and anatomical points of view. The authors present their experience in reconstructive surgery of the nasal tip, evaluating the results related to the use of flaps and free grafts. Among their cases, 132 patients were selected, with a prevalence of female patients, with a median age of 60. The deformities observed were postsurgical, following the exeresis of benign and malignant neoformations. The techniques utilized involved the use of median frontal, nasomental and nasolabial flaps. Of all of the patients treated, good aesthetic results were obtained in 79% of the cases, characterized by a good projection of the tip and by minor scar retraction, with full satisfaction on the part of the surgeon and the patient. On the other hand, some patients were defined as nonsatisfactory, with the deformity caused by scar retraction of the tip and abnormalities in color and thickness of the skin grafted. With a few exceptions, the patients had a good postoperative recovery without events worthy of note. On the basis of the results obtained, we can recommend advancement flap for lateral nasal defects, transposition of nasolabial flap for the reconstruction of the nasal alar. Naso-labial flaps with a subcutaneous pedicle are effective for correcting injures or defects involving the lateral surface of the nose.
鼻尖缺损在重建方面存在复杂问题，因为从功能和解剖学角度来看，它们都涉及一个重要区域。作者介绍了他们在鼻尖重建手术方面的经验，评估了与皮瓣和游离移植使用相关的结果。在他们的病例中，选择了132例患者，女性患者居多，中位年龄为60岁。观察到的畸形是在良性和恶性新生物切除术后出现的。所采用的技术包括使用额正中皮瓣、鼻颏皮瓣和鼻唇沟皮瓣。在所有接受治疗的患者中，79%的病例获得了良好的美学效果，其特征为鼻尖突出良好且瘢痕回缩轻微，外科医生和患者都完全满意。另一方面，一些患者被判定为不满意，存在鼻尖瘢痕回缩导致的畸形以及移植皮肤的颜色和厚度异常。除少数例外情况，患者术后恢复良好，无值得注意的事件发生。根据所获得的结果，我们推荐推进皮瓣用于鼻侧缺损，鼻唇沟皮瓣移位用于鼻翼重建。带皮下蒂的鼻唇沟皮瓣对于纠正涉及鼻侧面的损伤或缺损有效。
