Konofaos P, Alvarez S, McKinnie J E, Wallace R D
Department of Plastic Surgery, University of Tennessee Health Science Center, 910 Madison Ave, Room 315, Memphis, TN, 38103, USA.
Aesthetic Plast Surg. 2015 Feb;39(1):91-9. doi: 10.1007/s00266-014-0417-0. Epub 2014 Nov 21.
The purpose of this review is to examine a single surgeon's 10-year experience with nose defects and offer a simplified approach for nasal reconstruction to close most nasal defects following Mohs micrographic surgery (MMS).
A retrospective chart review was performed on patients undergoing repair of MMS defects of the nose over a 10-year period. Data collected included patients' age and sex, anatomic location of the defect, type of reconstruction, and number of operations required.
A total of 419 patients were included in this study. The most common location for nasal reconstruction was the nasal dorsum and sidewalls (66.35 %). Complications mainly related to reconstruction of defects of the tip ± ala (n = 31), followed by the ala (n = 15) and the dorsum and sidewalls (n = 13). Bulkiness of the flap used (n = 32) and hypertrophic scar (n = 13) were the most common complications. The bilobed flap was the most commonly used flap (n = 145), followed by nasolabial flap (n = 69), FTSGs (n = 63), forehead flap (n = 62), and dorsal glabellar flap (n = 44).
In this article, a simplified approach for nasal defects reconstruction is presented, which is based on commonly performed local flaps and skin grafting. This algorithm can be useful for the novice plastic surgeons in planning a reconstructive strategy that will be efficient, easy to perform, and produces an acceptable esthetic and functional outcome.
本综述的目的是研究一位外科医生在鼻缺损治疗方面的10年经验，并提供一种简化的鼻重建方法，以闭合莫氏显微外科手术（MMS）后大多数鼻缺损。
对10年间接受鼻MMS缺损修复的患者进行回顾性病历审查。收集的数据包括患者的年龄和性别、缺损的解剖位置、重建类型以及所需手术次数。
本研究共纳入419例患者。鼻重建最常见的部位是鼻背和侧壁（66.35%）。并发症主要与鼻尖±鼻翼缺损的重建有关（n = 31），其次是鼻翼（n = 15）以及鼻背和侧壁（n = 13）。所用皮瓣臃肿（n = 32）和瘢痕增生（n = 13）是最常见的并发症。双叶皮瓣是最常用的皮瓣（n = 145），其次是鼻唇沟皮瓣（n = 69）、全厚皮片移植（n = 63）、额部皮瓣（n = 62）和眉间皮瓣（n = 44）。
本文介绍了一种基于常用局部皮瓣和植皮的鼻缺损重建简化方法。该算法有助于初涉整形手术领域的医生制定一种高效、易于实施且能产生可接受的美学和功能效果的重建策略。
