Reddy Srinivas Gosla, Reddy Rajgopal R, Obwegeser Joachim, Mommaerts Maurice Y
GSR Institute of Craniofacial Surgery, Hyderabad, Telangana, India.
Children Hospital Zurich, University Zurich, Zurich, Switzerland.
Indian J Plast Surg. 2014 Sep-Dec;47(3):340-5. doi: 10.4103/0970-0358.146588.
Non-syndromic Tessier no. 2 and 3 facial clefts primarily affect the nasal complex. The anatomy of such clefts is such that the ala of the nose has a cleft. Repairing the ala presents some challenges to the surgeon, especially to correct the shape and missing tissue. Various techniques have been considered to repair these cleft defects.
We present two surgical options to repair such facial clefts.
A nasal dorsum rotational flap was used to treat patients with Tessier no. 2 clefts. This is a local flap that uses tissue from the dorsal surface of the nose. The advantage of this flap design is that it helps move the displaced ala of a Tessier no. 2 cleft into its normal position. A forehead-eyelid-nasal transposition flap design was used to treat patients with Tessier no. 3 clefts. This flap design includes three prongs that are rotated downward. A forehead flap is rotated into the area above the eyelid, the flap from above the eyelid is rotated to infra-orbital area and the flap from the infraorbital area that includes the free nasal ala of the cleft is rotated into place.
These two flap designs show good results and can be used to augment the treatment options for repairing Tessier no. 2 and 3 facial clefts.
非综合征性特西埃2号和3号面部裂隙主要影响鼻复合体。此类裂隙的解剖结构特点是鼻翼有裂隙。修复鼻翼对外科医生来说存在一些挑战，尤其是要矫正其形状和缺失的组织。人们已经考虑了多种技术来修复这些裂隙缺损。
我们提出两种修复此类面部裂隙的手术方案。
采用鼻背旋转皮瓣治疗特西埃2号裂隙患者。这是一种局部皮瓣，利用鼻背表面的组织。这种皮瓣设计的优点是有助于将特西埃2号裂隙移位的鼻翼移至正常位置。采用额-眼睑-鼻换位皮瓣设计治疗特西埃3号裂隙患者。这种皮瓣设计包括三个向下旋转的分支。额部皮瓣旋转至眼睑上方区域，眼睑上方的皮瓣旋转至眶下区域，包括裂隙游离鼻翼的眶下区域皮瓣旋转到位。
这两种皮瓣设计效果良好，可用于增加修复特西埃2号和3号面部裂隙的治疗选择。
