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鼻唇推进穿支皮瓣:解剖学研究及病例系列

Nasolabial propeller perforator flap: Anatomical study and case series.

作者信息

Posso Carolina, Delgado Anaya David, Aguilar Henao Jeison, Velasquez Gaviria Juan M

机构信息

Plastic and Reconstructive Surgery Service, Universidad de Antioquia, Medellín, Colombia.

Universidad de Antioquia, Medellín, Colombia.

出版信息

J Surg Oncol. 2018 Apr;117(5):1100-1106. doi: 10.1002/jso.25013. Epub 2018 Feb 26.

Abstract

PURPOSE

The previous cadaveric studies of facial artery perforators have frequently reported high variability, and those results remain to be validated in the Colombian population. Thus, we aimed to describe the vascular anatomy of the lateral nasal artery cutaneous branches and their clinical applications using Colombian cadavers.

MATERIALS AND METHODS

Nine hemifaces from six fresh cadavers were included in the study. Terminal branches of the facial artery and cutaneous perforators of the lateral nasal artery were dissected. The quality, number, and distribution of the perforators were assessed. In addition, we present results of seven clinical cases for nasal alar reconstruction.

RESULTS

Cutaneous perforators were found in all hemifaces, and zone 2 was the most common location. In our clinical case series, all flaps used to reconstruct the nasal alar defects survived. There were two cases of venous congestion but no additional procedures were needed.

CONCLUSIONS

Although nasal alar reconstruction continues to be a challenging plastic surgery procedure, the nasolabial propeller perforator flap is an excellent choice for such because it allows a precise skin island design, is less bulky, has a wide arc of rotation, and facilitates one-staged reconstruction without increasing the rate of complications.

摘要

目的

以往对面动脉穿支的尸体研究经常报告高度变异性,而这些结果仍有待在哥伦比亚人群中得到验证。因此,我们旨在利用哥伦比亚尸体描述鼻外侧动脉皮支的血管解剖及其临床应用。

材料与方法

本研究纳入了来自6具新鲜尸体的9个半侧面部。对面动脉的终末支和鼻外侧动脉的皮穿支进行解剖。评估穿支的质量、数量和分布。此外,我们还展示了7例鼻翼重建临床病例的结果。

结果

在所有半侧面部均发现了皮穿支,2区是最常见的位置。在我们的临床病例系列中,所有用于重建鼻翼缺损的皮瓣均存活。有2例出现静脉淤血,但无需额外手术。

结论

尽管鼻翼重建仍然是一项具有挑战性的整形手术,但鼻唇推进穿支皮瓣是此类手术的绝佳选择,因为它允许精确设计皮岛,体积较小,旋转弧宽,便于一期重建且不增加并发症发生率。

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