Takeda Akira, Akimoto Minekatsu, Park Keiichi, Kounoike Natsuko, Shimakura Yasuhito, Nemoto Mitsuru, Uchinuma Eiju
From the Department of Plastic and Aesthetic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
J Craniofac Surg. 2014 Nov;25(6):2144-6. doi: 10.1097/SCS.0000000000001141.
The reconstructive strategy for full-thickness nasal skin defects should include recreation of a cutaneous cover, support, and internal nasal lining. The most challenging aspect of this procedure is provision of the nasal lining. These reconstructions typically require a 2-step process. Satisfactory nasal skin reconstruction in a single operation is ideal.
We used a folded nasolabial flap combined with a turnover flap for reconstruction of full-thickness alar defects.
The donor material of the lining flap was a combination of the distal portion of the nasolabial flap and redundant skin resected during its transposition. The redundant skin flap was turned upside down, with the skin surface inside the nasal cavity. The remaining portion of the defect was covered with a folded nasolabial flap.
This procedure was successful in all 5 patients. All flaps survived completely without evidence of necrosis or narrowing of airways. Aesthetic concerns, including effacement of the nasofacial sulcus, were minor.
This method has the advantage of providing well-vascularized tissue of appropriate color, texture, and thickness for external coverage, as well as a satisfactory internal lining in a single-stage procedure.
全层鼻皮肤缺损的重建策略应包括重建皮肤覆盖、支撑结构和鼻内黏膜。该手术最具挑战性的方面是提供鼻黏膜。这些重建通常需要分两步进行。一次手术中实现满意的鼻皮肤重建是理想的。
我们采用折叠鼻唇瓣联合翻转瓣重建鼻翼全层缺损。
衬里瓣的供区材料是鼻唇瓣远端部分与移位过程中切除的多余皮肤的组合。将多余的皮瓣翻转，使皮肤面朝向鼻腔内部。缺损的其余部分用折叠鼻唇瓣覆盖。
该手术在所有5例患者中均获成功。所有皮瓣完全存活，无坏死或气道狭窄迹象。包括鼻面沟消失在内的美学问题轻微。
该方法的优点是在一期手术中为外部覆盖提供血运良好、颜色、质地和厚度合适的组织，以及令人满意的鼻内衬里。
