Ibrahimi Omar A, Campbell Tracy, Youker Summer, Eisen Daniel B
University of Connecticut, Department of Dermatology, Farmington, CT 06032, USA.
J Drugs Dermatol. 2012 Jan;11(1):46-50.
Defects of the distal nose, particularly the nasal ala, pose a reconstructive challenge due to the lack of loose adjacent tissue and proximity to a free margin.
We report our experience using nonanatomic free cartilage batten grafts in combination with second intention healing for nasal ala defects.
A retrospective study of distal nose defects repaired using nonanatomic free cartilage batten grafting with second intention healing was performed. Detailed data on the quality of the scar, post-operative complications, free margin distortion, functional impairments, and patient satisfaction were recorded. Digital images were also shown to an experienced fellowship-trained Mohs surgeon to assess the overall aesthetic outcome using a 5-point score ranging from poor to excellent.
Sixteen subjects were included in the study. Complications were common, but minor. Five (31%) subjects had subtle contour depressions, three (18%) subjects had excessive granulation tissue, two (12%) subjects had post-operative ear pain at the donor site lasting up to 10 days, and one (6%) subject had a hypertrophic scar at the recipient site. There were two occurrences (12%) of mild alar notching but no occurrences of significant alar margin distortion or nasal valve dysfunction. In terms of aesthetic outcome, seven (43%) were assessed by an independent fellowship-trained Mohs surgeon as having excellent aesthetic outcomes, six (38%) were very good, and three (19%) were good. All sixteen subjects reported satisfaction on follow-up evaluation.
Nonanatomic free cartilage grafting with second intention healing allows for facile, single-step repair of nasal ala defects with high patient satisfaction and aesthetically pleasing results. This provides an attractive alternative to other flap techniques, skin grafting, and healing via secondary intention.
鼻尖尤其是鼻翼的缺损，由于缺乏松弛的邻近组织且靠近游离边缘，给重建带来了挑战。
我们报告使用非解剖游离软骨板条移植联合二期愈合治疗鼻翼缺损的经验。
对采用非解剖游离软骨板条移植联合二期愈合修复鼻尖缺损进行回顾性研究。记录瘢痕质量、术后并发症、游离边缘变形、功能障碍和患者满意度的详细数据。还将数字图像展示给一位经验丰富的接受过专科培训的莫氏外科医生，以使用从差到优的5分制评分来评估整体美学效果。
16名受试者纳入研究。并发症常见但轻微。5名（约31%）受试者有轻微的轮廓凹陷，3名（约18%）受试者有过度增生的肉芽组织，2名（约12%）受试者供区术后耳部疼痛持续长达10天，1名（约6%）受试者受区有增生性瘢痕。有2例（约12%）出现轻度鼻翼切迹，但未出现明显的鼻翼边缘变形或鼻瓣功能障碍。在美学效果方面，7名（约43%）经独立的接受过专科培训的莫氏外科医生评估为具有极佳的美学效果，6名（约38%）非常好，3名（约19%）良好。所有16名受试者在随访评估中均表示满意。
非解剖游离软骨移植联合二期愈合可轻松、单步修复鼻翼缺损，患者满意度高，美学效果良好。这为其他皮瓣技术、植皮和二期愈合提供了有吸引力的替代方案。
