Skin Cancer Institute, Dermatological Surgical Unit, Tauranga, New Zealand.
J Am Acad Dermatol. 2012 Oct;67(4):712-6. doi: 10.1016/j.jaad.2012.03.025. Epub 2012 Jun 8.
Defects of the distal nose and nasal tip are inherently challenging to reconstruct. Although the bilobed flap has a pivotal role for the closure of such defects to achieve a satisfactory outcome, it demands meticulous planning and execution.
We sought to present our experience of the advancement and inferior rotation of the nasal sidewall (AIRNS) flap as a possible alternative to the bilobed flap for reconstruction of the distal nose.
All patients who underwent AIRNS repair after Mohs tumor extirpation of the nose at 2 regional skin cancer units since April 2011 were reviewed.
In all, 45 patients underwent the AIRNS flap repair. There were 25 men and 20 women, with a mean age of 70 years (range 41-88). The average defect size was 1.2 × 1.2 cm. The majority of cases involved the nasal tip. A single case of postoperative infection occurred in a smoker, which resolved without any long-term sequelae. No cases of flap necrosis or nasal airflow obstruction were seen. All cases produced good or excellent cosmetic results.
Because of blunting of the superior alar crease, which may be avoided in a bilobed repair, the AIRNS flap is best avoided in laterally based defects of the nasal alar.
The AIRNS flap is a reliable, single-stage closure option that, in our opinion, is simpler in design and execution compared with the bilobed flap and thus adds to the reconstructive surgeon's armamentarium when faced with centrally located defects of the distal nose.
远端鼻和鼻尖的缺陷重建具有固有挑战性。虽然双叶皮瓣在关闭此类缺陷以获得满意结果方面具有关键作用，但它需要精细的规划和执行。
我们旨在介绍我们在鼻侧推进和下旋皮瓣（AIRNS）作为替代双叶皮瓣修复远端鼻的经验。
回顾了自 2011 年 4 月以来在 2 个区域皮肤癌单位接受 Mohs 肿瘤切除后进行 AIRNS 修复的所有患者。
共有 45 例患者接受了 AIRNS 皮瓣修复。其中 25 例为男性，20 例为女性，平均年龄为 70 岁（范围为 41-88 岁）。平均缺损大小为 1.2×1.2cm。大多数病例涉及鼻尖。1 例吸烟者术后感染，无长期后遗症。未发生皮瓣坏死或鼻气流阻塞。所有病例均产生良好或优秀的美容效果。
由于上唇皱襞变钝，这在双叶修复中可能避免，因此 AIRNS 皮瓣最好避免在鼻翼外侧的基于侧位的缺陷中使用。
AIRNS 皮瓣是一种可靠的单阶段闭合选择，在我们看来，与双叶皮瓣相比，设计和执行更简单，因此当面对远端鼻中心位置的缺陷时，为重建外科医生提供了更多的选择。
