Yalamanchili Haresh, Sclafani Anthony P, Schaefer Steven D, Presti Paul
Department of Otolaryngology, The New York Eye & Ear Infirmary, New York, New York 10003, USA.
Facial Plast Surg. 2008 Jan;24(1):3-10. doi: 10.1055/s-2007-1021457.
Nasal reconstruction, first described over 2600 years ago in India, has undergone several modifications in its development. However, there is a misconception that this surgery began with the forehead flap repair, and the history of the subsequent two and a half millennia is poorly represented in most surgical texts. This article presents a review of the historical significance of nasal injuries in antiquity and the various technical developments along the path to modern nasal reconstruction, from ancient India through medieval Europe to modern England and America. Although written texts from 6th-century BC India through 16th-century AD Europe described pedicle flap repair of nasal defects, it was not until the late 18th century that the first written description of the forehead flap appeared. Forehead flap repair developed on an alternate pathway, being transmitted via an oral tradition, typically within families of craftsmen, at least as early as the 14th century. These ancient authors recognized the need for accurate flap design and sizing, donor site repair, precise tissue apposition, protection of the flap pedicle, hemostasis, deepithelialization of the wound, and replacement of intranasal lining. By appreciating ancient surgical techniques and examining the particular issues these procedures attempted to address, the surgeon will gain an additional and more detailed perspective of nasal reconstruction that will aid in providing excellent care to his patients.
鼻再造术早在2600多年前就已在印度被首次描述，在其发展过程中经历了多次改进。然而，有一种误解认为这种手术始于额部皮瓣修复，而在大多数外科文献中，随后两千五百年的历史却鲜有记载。本文回顾了古代鼻外伤的历史意义以及从古代印度到中世纪欧洲再到现代英美，通往现代鼻再造术的各种技术发展。尽管从公元前6世纪的印度到公元16世纪的欧洲的书面文献都描述了鼻缺损的带蒂皮瓣修复，但直到18世纪后期才首次出现额部皮瓣的书面描述。额部皮瓣修复是通过另一条途径发展起来的，至少早在14世纪就通过口头传统传播，通常是在工匠家族内部。这些古代作者认识到精确皮瓣设计和尺寸确定、供区修复、精确组织对位、皮瓣蒂部保护、止血、伤口去上皮化以及鼻内衬里置换的必要性。通过了解古代手术技术并审视这些手术试图解决的特定问题，外科医生将获得关于鼻再造术的更多详细视角，这将有助于为患者提供优质护理。
