Eskiizmir Görkem, Hırçın H Zafer, Celik Onur, Unlü Halis
Department of Otolaryngology, Medicine Faculty of Celal Bayar University, Manisa, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2011 Jan-Feb;21(1):1-9.
In this study, we evaluated the patients, who underwent nasal reconstruction with local nasal or regional flaps and compared our approach with the algorithms of nasal reconstruction in literature.
Twenty-seven patients (15 males, 12 females; mean age 68.7 years; range 42 to 86 years) who underwent nasal reconstruction with local nasal or regional flaps due to excision of skin cancers on the nose, between November 2007 and December 2009 were included in this study. The demographic data (age, sex and occupation), the location, histopathologic type, subtype and size of the tumor, the size and thickness of the defect area, the reconstruction technique and complications were recorded. All patients were photo-documented pre-, intra- and postoperatively, and were followed up at regular intervals.
Basal cell carcinoma was detected in 23 patients and squamous cell carcinoma was detected in four patients. The tumors were most frequently located on the nasal dorsum (n=8, 29%) and the side walls (n=6, 22%). The tumor size was >15 mm in 14 (52%) patients. The size of the nasal defect was >20 mm in 18 (66%) patients. Reconstruction was performed with local nasal flaps in 10 patients and with regional flaps in 17 patients.
The surgical flaps for nasal reconstruction should be selected individually. The ideal technique of nasal reconstruction should be determined based on the location, size, and thickness of the nasal defects, the preferences of the patients and the surgeon's experience.
在本研究中,我们评估了接受局部鼻瓣或区域皮瓣鼻再造术的患者,并将我们的方法与文献中的鼻再造算法进行了比较。
本研究纳入了2007年11月至2009年12月期间因鼻部皮肤癌切除而接受局部鼻瓣或区域皮瓣鼻再造术的27例患者(15例男性,12例女性;平均年龄68.7岁;范围42至86岁)。记录了人口统计学数据(年龄、性别和职业)、肿瘤的位置、组织病理学类型、亚型和大小、缺损区域的大小和厚度、重建技术及并发症。所有患者在术前、术中和术后均进行了照片记录,并定期进行随访。
23例患者检测出基底细胞癌,4例患者检测出鳞状细胞癌。肿瘤最常见于鼻背(n = 8,29%)和侧壁(n = 6,22%)。14例(52%)患者的肿瘤大小>15 mm。18例(66%)患者的鼻缺损大小>20 mm。10例患者采用局部鼻瓣进行重建,17例患者采用区域皮瓣进行重建。
鼻再造的手术皮瓣应个体化选择。应根据鼻缺损的位置、大小和厚度、患者的偏好以及外科医生的经验来确定理想的鼻再造技术。