Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Semin Plast Surg. 2008 Nov;22(4):257-68. doi: 10.1055/s-0028-1095885.
Nasal reconstruction continues to be a formidable challenge for most plastic surgeons. This article provides an overview of nasal reconstruction with brief descriptions of subtle nuances involving certain techniques that the authors believe help their overall outcomes. The major aspects of nasal reconstruction are included: lining, support, skin coverage, local nasal flaps, nasolabial flap, and paramedian forehead flap. The controversy of the subunit reconstruction versus defect-only reconstruction is briefly discussed. The authors believe that strictly adhering to one principle or another limits one's options, and the patient will benefit more if one is able to apply a variety of options for each individualized defect. A different approach to full-thickness skin grafting is also briefly discussed as the authors propose its utility in lower third reconstruction. In general, the surgeon should approach each patient as a distinct individual with a unique defect and thus tailor each reconstruction to fit the patient's needs and expectations. Postoperative care, including dermabrasion, skin care, and counseling, cannot be understated.
对于大多数整形外科医生来说，鼻重建仍然是一个艰巨的挑战。本文概述了鼻重建，简要描述了作者认为有助于提高整体效果的某些技术的细微差别。鼻重建的主要方面包括：衬里、支撑、皮肤覆盖、局部鼻皮瓣、鼻唇沟皮瓣和正中额部皮瓣。 subunit 重建与仅缺陷重建的争议也做了简要讨论。作者认为，严格坚持一种原则或另一种原则会限制选择，而如果能够为每个个体化缺陷应用多种选择，患者将获益更多。全厚皮片移植的另一种方法也做了简要讨论，因为作者提出其在中下三分之一重建中的应用。一般来说，外科医生应该将每个患者作为一个具有独特缺陷的独特个体来对待，因此根据患者的需求和期望来定制每个重建。术后护理，包括磨皮、皮肤护理和咨询，不容忽视。
