Masic Tark, Lincender Ivor, Dizdarevic Dino
Clinic of Maxillofacial Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
Med Arh. 2010;64(2):110-2.
Reconstruction of nose defects after tumor resection, trauma or infection disease is imperative for full patient rehabilitation. For satisfying esthetic and functional results achievement, it is necessary to use surrounding skin with similar semblance, which precisely restores and imitates missing part with its outlines.
This paper represents management of the patients with subtotal and total nose defects using forehead and nasolabial flaps. During a period from 2007 to 2010, 20 patients with total or subtotal nasal defects were observed. Among them, 6 defects had traumatic etiology and 14 of them resulted after tumor resection. All of them were full thickness defects overtaking the nasal mucosa, skin of the nasal antechamber, cartilage frame and external nasal skin. In all cases there was indication for local flap reconstruction. Median forehead flap has been used in 12 cases and nasolabial flap in 6 cases. Combination of these two flaps has been used in 2 cases.
Good and satisfying results were achieved in all of 20 cases, except for one speech dysfunction. Nose function was maintained with proper porosity of the nostril. Three-dimensional appearance of the nose was reconstructed with achievement of acceptable esthetics results.
Because of its good vascularisation, adaptability, color and outlining without hair, nasolabial and median forehead flap, as well as surrounding area flaps are the most frequent used flaps in nose defect reconstruction.
对于肿瘤切除、外伤或感染性疾病后鼻缺损的修复,对患者的全面康复至关重要。为了获得满意的美学和功能效果,有必要使用外观相似的周围皮肤,它能精确地恢复并模仿缺失部分的轮廓。
本文介绍了使用额部皮瓣和鼻唇沟皮瓣治疗部分和全鼻缺损患者的情况。在2007年至2010年期间,观察了20例部分或全鼻缺损患者。其中,6例缺损为外伤所致,14例为肿瘤切除后所致。所有患者均为全层缺损,累及鼻黏膜、鼻前庭皮肤、软骨支架和鼻外皮肤。所有病例均有局部皮瓣重建的指征。12例采用正中额部皮瓣,6例采用鼻唇沟皮瓣。2例采用这两种皮瓣联合应用。
20例患者中,除1例出现言语功能障碍外,其余均取得了良好和满意的效果。鼻孔保持适当的孔隙率,维持了鼻功能。重建了鼻子的三维外观,取得了可接受的美学效果。
由于鼻唇沟皮瓣和正中额部皮瓣以及周围区域皮瓣血管化良好、适应性强、颜色和轮廓无毛发,是鼻缺损重建中最常用的皮瓣。