Jung Dong-Hak, Chang Geun-Uck, Baek Seung-Hak, Lee Yong-Kwon, Choi Jin-Young
Shimmian Rhinoplasty Clinic, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea.
J Craniofac Surg. 2010 Jan;21(1):146-50. doi: 10.1097/SCS.0b013e3181c46bd8.
To present the effects of subnasale (SN) flap on the correction of deviated columella base in patients with secondary unilateral cleft lip nasal (UCLN) deformity.
The patients were 6 adult Koreans with cleft cases (mean age, 29.1 y; range, 20-43 y; 1 man and 5 women; secondary UCLN deformity with columella base deviation). After the open rhinoplasty with the Padovan incision had been completed for correction of the secondary UCLN deformity, the SN flap was used for correction of the deviated columella base. The design of the SN flap started from the central portion of the SN region that will be the reconstructed columella and extended to the nasal floor in the larger nostril site. Then, the SN flap was transposed into the smaller nostril site. The columella skin was also elevated and placed into the larger nostril site with the distal end inserting into the donor site. The patients' follow-up period was 16 to 40 months.
The SN flap after the open rhinoplasty with the Padovan incision resulted in minimal scarring on the donor and recipient sites. The deviated columella base was straightened in all cases. During the surgical follow-up period, there was no recurrence of the columella base deviation in any patient and no other noteworthy complications were found.
For correction of the columella base deviation in patients with secondary UCLN deformity, the SN flap can be a viable treatment option.
探讨鼻小柱基部皮瓣(SN皮瓣)对二期单侧唇裂鼻畸形(UCLN)患者鼻中隔偏曲矫正的效果。
6例成年韩国唇裂患者(平均年龄29.1岁;范围20 - 43岁;男1例,女5例;二期UCLN畸形伴鼻中隔基部偏曲)。在采用帕多瓦切口进行开放性鼻整形术以矫正二期UCLN畸形后,使用SN皮瓣矫正鼻中隔基部偏曲。SN皮瓣的设计从将重建鼻中隔的鼻小柱区域中央部分开始,延伸至较大鼻孔侧的鼻底。然后,将SN皮瓣转移至较小鼻孔侧。同时掀起鼻中隔皮肤并置于较大鼻孔侧,其远端插入供区。患者随访期为16至40个月。
采用帕多瓦切口进行开放性鼻整形术后的SN皮瓣在供区和受区产生的瘢痕最小。所有病例中偏曲的鼻中隔基部均得以矫正。在手术随访期间,所有患者均未出现鼻中隔基部偏曲复发,也未发现其他值得注意的并发症。
对于二期UCLN畸形患者鼻中隔基部偏曲的矫正,SN皮瓣可能是一种可行的治疗选择。