Choe Yun Seon, Kim Min-Woo, Jo Seong Jin
Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
Ann Dermatol. 2015 Dec;27(6):748-50. doi: 10.5021/ad.2015.27.6.748. Epub 2015 Dec 7.
In full-thickness defects of the nasal alar rim, to achieve projection and maintain airway patency, cartilage graft is frequently needed. However, cartilage graft presents a challenge in considerations such as appropriate donor site, skeletal shape and size, and healing of the donor area. To avoid these demerits, we tried primary closure of alar rim defects by also making the contralateral normal ala smaller. We treated two patients who had a full-thickness nasal alar defect after tumor excision. Cartilage graft was considered for the reconstruction. However, their alar rims were overly curved and their nostril openings were large. To utilize their nasal shape, we did primary closure of the defect rather than cartilage graft, and then downsized the contralateral nasal ala by means of wedge resection to make the alae symmetric. Both patients were satisfied with their aesthetic results, which showed a smaller nostril and nearly straight alar rims. Moreover, functionally, there was no discomfort during breathing in both patients. We propose our idea as one of the reconstruction options for nasal alar defects. It is a simple and easy-to-perform procedure, in addition to enhancing the nasal contour. This method would be useful for patients with a large nostril and an overly curved alar rim.
在鼻翼边缘全层缺损的情况下，为了实现鼻翼突出并保持气道通畅，通常需要软骨移植。然而，软骨移植在合适的供区、骨骼形状和大小以及供区愈合等方面存在挑战。为避免这些缺点，我们尝试通过缩小对侧正常鼻翼来对鼻翼边缘缺损进行一期缝合。我们治疗了两名肿瘤切除后出现鼻翼全层缺损的患者。考虑采用软骨移植进行重建。然而，他们的鼻翼边缘过度弯曲，鼻孔开口较大。为利用他们的鼻形，我们对缺损进行了一期缝合而非软骨移植，然后通过楔形切除术缩小对侧鼻翼，以使鼻翼对称。两名患者对美学效果均满意，表现为鼻孔变小且鼻翼边缘近乎笔直。此外，在功能上，两名患者呼吸时均无不适。我们提出我们的想法作为鼻翼缺损重建的选择之一。这是一种简单且易于实施的手术，除了能改善鼻外形外。该方法对鼻孔大且鼻翼边缘过度弯曲的患者有用。
