Friel Michael T, Flores Roberto L
Department of Plastic Surgery, Ochsner Clinic Foundation, New Orleans, LA.
Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, NY.
Ochsner J. 2018 Summer;18(2):176-179. doi: 10.31486/toj.17.0052.
In the subunit principle of nasal reconstruction, the valleys and low ridges of the nose are designated as topographic subunits. Surgical scars can be located at the borders of subunits to hide their appearance.
A 30-month-old female presented with an obstructing nasal glial heterotopia (nasal glioma). Using the nasal subunit approach, the mass was exposed using an incision along the subunit borders of the nose. The nasal glioma was completely resected, and the internal nasal valve and the deformed lower lateral cartilages were reconstructed through the subunit approach access incision. The final scar was placed along the subunit borders of the nose. At 6-month follow-up, the patient demonstrated no airway obstruction, adequate nasal contour, and an esthetic nasal scar.
The subunit approach for a large, obstructing nasal glial heterotopia allows direct exposure for tumor resection, framework reconstruction, placement of the incision in an esthetic location, and excision of the expanded skin for recontouring of the skin envelope.
在鼻再造的亚单位原则中,鼻的沟谷和低嵴被指定为地形亚单位。手术瘢痕可位于亚单位边界处以隐藏其外观。
一名30个月大的女性患有阻塞性鼻胶质异位(鼻胶质瘤)。采用鼻亚单位入路,沿鼻亚单位边界作切口暴露肿块。鼻胶质瘤被完全切除,并通过亚单位入路切口重建鼻内瓣膜和变形的下外侧软骨。最终瘢痕位于鼻亚单位边界处。随访6个月时,患者无气道阻塞,鼻外形良好,鼻瘢痕美观。
对于大型阻塞性鼻胶质异位,亚单位入路可直接暴露肿瘤以进行切除、支架重建,将切口置于美观位置,并切除多余皮肤以重塑皮肤包膜。