Valentini Valentino, Terenzi Valentina, Bartoli Davina, Battisti Andrea, Aboh Ikenna Valentine, Egidi Sara, Cassoni Andrea
Maxillo-Facial Surgery Department, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
J Craniofac Surg. 2012 Sep;23(5):e474-6. doi: 10.1097/SCS.0b013e31825878ef.
Nasal defects resulting from tumor excision can be classified according to tissues involved, such as skin, cartilage, and bone. Although in the case of "simple" defects, reconstruction with loco-regional flap eventually associated with cartilage grafts can lead to satisfactory results; in the case of total or partial rhinectomy, a minimum of 3 and a maximum of 7 operations have to be performed in the current series to achieve an acceptable end result. We present the case of a total rhinectomy reconstruction in a single-step procedure with an osteocutaneous forearm free flap (RFOFF).
A 50-year-old man underwent total rhinectomy to excise a pathologically proven T4aN0 moderately differentiated squamous cell carcinoma of the nose; contemporary single-step reconstruction with an RFOFF was performed. Adjuvant radiotherapy was performed.
At 18 months of follow-up, the patient is free of disease and no postirradiation flap damage has been experienced; the flap notably did not appear to be bulky.
We believe that the RFOFF is morphologically and functionally better than other flaps owing to its capability to adapt to the new environments of the nasal cavity, and to avoid, when possible, a three-dimensional reconstruction of the same.
因肿瘤切除导致的鼻缺损可根据所累及的组织进行分类，如皮肤、软骨和骨。尽管对于“简单”缺损，采用最终联合软骨移植的局部皮瓣重建可取得满意效果；但在全鼻或部分鼻切除的情况下，在当前系列病例中，最少需进行3次、最多需进行7次手术才能获得可接受的最终结果。我们介绍了一例采用骨皮瓣游离前臂皮瓣（RFOFF）进行单步全鼻切除重建的病例。
一名50岁男性接受了全鼻切除术，以切除经病理证实的鼻部T4aN0中度分化鳞状细胞癌；同时采用RFOFF进行了单步重建。进行了辅助放疗。
随访18个月时，患者无疾病复发，未出现放疗后皮瓣损伤；皮瓣明显未显得臃肿。
我们认为，RFOFF在形态和功能上优于其他皮瓣，因为它能够适应鼻腔的新环境，并尽可能避免对其进行三维重建。
