Kim Y J, Cho H H, Kim S O, Lee J B, Lee S C
Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea.
Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea.
Clin Exp Dermatol. 2015 Oct;40(7):728-34. doi: 10.1111/ced.12676. Epub 2015 May 11.
Basal cell carcinoma (BCC) often occurs on the nose. Reconstruction of the nose should yield excellent aesthetic and functional outcomes.
We propose a technical algorithm for the reconstruction of surgical defects, based on our analysis of 221 cases of nasal BCC with skin involvement only, which could be repaired by minor surgery.
The aesthetic and functional outcomes for various reconstruction techniques were analysed according to defect location and size. A reconstruction algorithm was proposed with the aim of obtaining the best surgical results.
Defect location and size were key considerations. Primary closure was the first option for small defects (< 10 mm), with scores of 3.4 for objective aesthetic outcome (OAO), 3.2 for subjective aesthetic outcome (SAO) and 3.3 for subjective functional outcome (SFO). The first option for medium defects (1-20 mm) was the island pedicle flap, with scores of 3.5 for OAO, 3.2 for SAO and 3.7 for SFO. The first option for large defects (> 20 mm) was the transposition flap for the upper nose (scores of 2.0 for OAO and SAO and 3.0 for SFO) and the interpolation flap for the lower nose (2.8 for OAO and 2.9 for SAO and SFO).
We have proposed an algorithm to select the optimal technique for repairing nasal BCC surgical defects according to their size and location.
基底细胞癌（BCC）常发生于鼻部。鼻部重建应取得优异的美学和功能效果。
基于对221例仅累及皮肤的鼻部基底细胞癌病例的分析，我们提出一种手术缺损重建的技术算法，这些病例可通过小手术修复。
根据缺损部位和大小分析各种重建技术的美学和功能效果。提出一种重建算法，旨在获得最佳手术效果。
缺损部位和大小是关键考虑因素。对于小缺损（<10毫米），一期缝合是首选，客观美学效果（OAO）评分为3.4，主观美学效果（SAO）评分为3.2，主观功能效果（SFO）评分为3.3。对于中等缺损（10-20毫米），首选岛状蒂皮瓣，OAO评分为3.5，SAO评分为3.2，SFO评分为3.7。对于大缺损（>20毫米），鼻上部首选移位皮瓣（OAO和SAO评分为2.0，SFO评分为3.0），鼻下部首选插入皮瓣（OAO评分为2.8，SAO和SFO评分为2.9）。
我们提出了一种算法，可根据手术缺损的大小和部位选择修复鼻部基底细胞癌的最佳技术。
