Moyer Jeffrey S
Center for Facial Cosmetic Surgery, University of Michigan Medical Center, Ann Arbor, 48109, USA.
Ann Plast Surg. 2010 Aug;65(2):188-92. doi: 10.1097/SAP.0b013e3181c71429.
Reconstruction of near-total and total nasal defects is technically challenging, particularly in patients with an extensive smoking history. One of the keys to a successful esthetic and functional reconstruction is the use of intranasal lining that is reliable and not susceptible to necrosis. Unlike mucosal flaps and skin turn-in flaps with a random blood supply, paramedian forehead flaps have an axial blood supply and are less likely to be adversely affected by a patient's smoking history. In this report, we describe the use of staged bilateral paramedian forehead flaps as an alternative technique for patients with isolated near-total or total nasal defects where local tissue is of insufficient quality or quantity for intranasal flap design. The use of staged bilateral forehead flaps can result in acceptable functional and esthetic outcomes in patients with extensive nasal defects.
近乎全鼻和全鼻缺损的重建在技术上具有挑战性，尤其是对于有大量吸烟史的患者。成功进行美学和功能重建的关键之一是使用可靠且不易发生坏死的鼻内衬里。与随机血供的黏膜瓣和皮肤内卷瓣不同，正中旁前额瓣具有轴型血供，受患者吸烟史的不利影响较小。在本报告中，我们描述了分期双侧正中旁前额瓣的使用，作为一种替代技术，用于局部组织质量或数量不足以设计鼻内瓣的孤立性近乎全鼻或全鼻缺损患者。分期双侧前额瓣的使用可使广泛鼻缺损患者获得可接受的功能和美学效果。
