Patel Payal M, Greenberg Judah N, Kreicher Kathryn L, Burkemper Nicole M, Bordeaux Jeremy S, Maher Ian A
Department of Dermatology, St. Louis University School of Medicine, St. Louis, Missouri.
Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Dermatol Surg. 2018 Jun;44(6):785-795. doi: 10.1097/DSS.0000000000001471.
The paramedian forehead flap (PMFF) is the repair of choice for large nasal defects involving multiple cosmetic subunits. However, the PMFF may not be optimal for all patients. The combination of a melolabial interpolation flap (MLIF) and a nasal sidewall flap may serve as an alternative.
To present the surgical technique and aesthetic outcomes of the alternative reconstruction for surgical defects of the lower nose.
Fourteen patients with multisubunit nasal Mohs defects reconstructed alternatively were identified from 2 academic centers in this retrospective case series. Illustrations and photographs were used to demonstrate surgical technique and outcomes. Final aesthetic results were analyzed using the Patient and Observer Scar Assessment Scale.
The physician observer rated the scar outcome a mean score of 10.9 ± 3.3. Patients rated their results as a mean of 9.1 ± 4.7. The mean "Patient" Overall Opinion score was 2.3 ± 2.6 and the mean "Observer" Overall Opinion score was 1.9 ± 0.9. No patients reported problems with nasal airflow or obstruction, and cosmetic complications such as pincushioning or alar buckling were not observed.
The combined MLIF and nasal sidewall flap is an alternative repair for complex distal nasal defects.
正中旁前额皮瓣(PMFF)是修复涉及多个美容亚单位的大型鼻缺损的首选方法。然而,PMFF可能并非对所有患者都是最佳选择。鼻唇沟插入皮瓣(MLIF)和鼻侧壁皮瓣的联合应用可能是一种替代方案。
介绍下鼻手术缺损的替代重建手术技术及美学效果。
在这个回顾性病例系列中,从2个学术中心确定了14例接受替代重建的多亚单位鼻Mohs缺损患者。使用插图和照片展示手术技术及结果。使用患者和观察者瘢痕评估量表分析最终美学效果。
医生观察者对瘢痕结果的评分平均为10.9±3.3。患者对其结果的评分平均为9.1±4.7。“患者”总体意见评分平均为2.3±2.6,“观察者”总体意见评分平均为为1.9±0.9。没有患者报告鼻气流或阻塞问题,也未观察到诸如针垫样或鼻翼皱缩等美容并发症。
MLIF和鼻侧壁皮瓣联合是复杂鼻远端缺损的一种替代修复方法。