Ghassemi A, Ahmed S S, Ghanepur H, Modabber A
Klinikum Lippe, Academic Hospital of the University of Hannover, Detmold, Germany; Medical Faculty, RWTH Aachen University, Aachen, Germany.
Oral and Maxillofacial Surgery, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, India.
Int J Oral Maxillofac Surg. 2017 Jan;46(1):36-40. doi: 10.1016/j.ijom.2016.08.024. Epub 2016 Oct 23.
The reconstruction of a full-thickness defect of the distal third of the nose requires the restoration of all three anatomical layers. A practical method for three-layer reconstruction of the lower third of the nose and the long-term results of this technique are presented herein. A combined reconstruction technique was utilized, including a reverse subcutaneous pedicled nasolabial flap to restore the nasal mucosa, an auricular cartilage graft for structural support, and a forehead flap for cutaneous coverage of the defect. This technique was applied in 21 patients following the full-thickness excision of basal cell carcinoma of the lower part of the nose. All patients (12 male and nine female; mean age 59.8 years) were treated successfully and were satisfied with the aesthetic and functional outcomes. The wound had to be further revised in three cases for the correction of contour or residual deformities; however, no further complications were experienced. One patient had a wound infection and the cartilage had to be removed. The grafting procedure was repeated successfully after resolution of the infection. Donor site morbidity was unremarkable. Combined flaps from the forehead and nasolabial regions with an incorporated auricular cartilage graft can be used to reconstruct full-thickness defects of the lower third of the nose.
鼻远端三分之一全层缺损的重建需要恢复所有三个解剖层次。本文介绍一种鼻下三分之一三层重建的实用方法及其长期效果。采用了一种联合重建技术，包括用逆行皮下蒂鼻唇瓣修复鼻黏膜、用耳软骨移植提供结构支撑以及用额瓣覆盖缺损皮肤。该技术应用于21例鼻下部基底细胞癌全层切除术后的患者。所有患者（12例男性和9例女性；平均年龄59.8岁）均成功治疗，对美学和功能效果满意。3例患者因轮廓矫正或残留畸形需进一步修整伤口；然而，未出现其他并发症。1例患者伤口感染，不得不取出软骨。感染消退后成功重复了移植手术。供区并发症不明显。前额和鼻唇区域联合皮瓣并植入耳软骨移植可用于重建鼻下三分之一的全层缺损。
