Kovacevic Predrag, Hrgovic Igor, Kovacevic Tatjana, Hrgovic Zlatko
Department of plastic and reconstructive Surgery, Faculty of medicine, University Nis, Serbia.
Department of Dermatology, University hospital J. W. Goethe, Frankfurt, Germany.
Med Arch. 2013 Dec;67(6):450-3. doi: 10.5455/medarh.2013.67.450-453. Epub 2013 Dec 28.
The reconstruction of fullthickness nasal alla defects is challenging procedure. Use of local flaps is acceptable approach. Flap based on infraorbital artery could be used for primary reconstruction of nasal ala defects.
The prospective study include consecutive series of 15 patients with advanced skin carcinoma of the nasal ala and medial cheek staged T4 by TNM, in whom the turn in infraorbital flap was used. The patient characteristics, type of carcinoma and complications were analyzed.
The turn in infraorbital flap was used mostly in male patients (80%), mean age 64 years. The basal cell skin carcinoma was found in 60%. Skin layer was skin grafted. All flaps survived, but in one case a partial wound dehiscence in one partial skin graft loss was found, and in two patients partial nasal obstruction occurred. These three complications were solved as secondary procedures under local anesthesia.
Full-thickness defect of the nasal ala can be properly reconstructed using flap based on infraorbital artery providing exceptional esthetic and functional results, as single stage procedure.
全层鼻翼缺损的重建是一项具有挑战性的手术。使用局部皮瓣是一种可接受的方法。基于眶下动脉的皮瓣可用于鼻翼缺损的一期重建。
这项前瞻性研究纳入了连续15例经TNM分期为T4期的晚期鼻翼及内侧脸颊皮肤癌患者，他们均采用了眶下皮瓣翻转术。分析了患者的特征、癌症类型及并发症。
眶下皮瓣翻转术主要用于男性患者（80%），平均年龄64岁。60%的患者为基底细胞皮肤癌。对皮肤层进行了植皮。所有皮瓣均存活，但1例出现部分伤口裂开伴局部植皮丢失，2例患者出现部分鼻塞。这三种并发症均在局部麻醉下作为二期手术解决。
使用基于眶下动脉的皮瓣可对全层鼻翼缺损进行恰当重建，作为单阶段手术可提供优异的美学和功能效果。
