Akhoondinasab Mohammad Reza, Saboury Mahdy, Shafaeei Yousef, Forghani Siamak, Fatemi Mohammad Javad
Department of Plastic and Reconstructive Surgery, St. Fatima Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
World J Plast Surg. 2020 Jan;9(1):39-43. doi: 10.29252/wjps.9.1.39.
Phalloplasty is the most amazing reconstructive surgery, and has a vital role in the quality of life of transsexual patients. There are several techniques for glans sculpting, but none of them had long-lasting results. In the present study, a new technique was introduced and compared with Norfolk technique for coronaplasty following phalloplasty.
In the present randomized controlled study, 40 transgender patients were enrolled from February 2016 to December 2018, at St. Fatima Plastic and Reconstructive Surgery Center. The patients were randomly assigned in two groups including 20 patients with anterolateral thigh flap (ALT)/radial forearm free flap (RFFF) phalloplasty followed with our new coronaplasty technique (group 1) and 20 patients with ALT flap/RFFF phalloplasty followed with Norfolk technique (group 2).
Almost 85% of the patients underwent the surgery with the new technique were satisfied with the outcome of surgery and considered it acceptable within 6-month follow-up, however, only 70% of the patients in Norfolk technique group reported acceptable results, which was significantly lower than the new technique. Similarly, within 12-month follow-up, 80 and 40% of the patients, respectively in new and Norfolk groups reported acceptable results, which was also significantly higher in the new technique.
This new technique showed remarkably better results relative to the usual technique for glans sculpting in transsexual patients. Moreover, it had the ability to be easily applied along with ALT/RFFF flaps in both immediate and delayed situations.
阴茎成形术是最令人惊叹的重建手术，对变性患者的生活质量起着至关重要的作用。有几种龟头塑形技术，但都没有持久的效果。在本研究中，引入了一种新技术，并与阴茎成形术后冠状成形术的诺福克技术进行了比较。
在本随机对照研究中，2016年2月至2018年12月期间，在圣法蒂玛整形与重建外科中心招募了40名 transgender 患者。患者被随机分为两组，包括20例行股前外侧皮瓣（ALT）/桡骨前臂游离皮瓣（RFFF）阴茎成形术并采用我们新的冠状成形术技术的患者（第1组）和20例行ALT皮瓣/RFFF阴茎成形术并采用诺福克技术的患者（第2组）。
采用新技术进行手术的患者中，近85%对手术结果满意，并在6个月的随访期内认为其可接受，然而，诺福克技术组中只有70%的患者报告结果可接受，明显低于新技术组。同样，在12个月的随访中，新技术组和诺福克组分别有80%和40%的患者报告结果可接受，新技术组的比例也明显更高。
相对于变性患者常用的龟头塑形技术，这种新技术显示出明显更好的效果。此外，它能够在即时和延迟情况下与ALT/RFFF皮瓣一起轻松应用。
