Gasteratos Konstantinos, Spyropoulou Georgia-Alexandra, Chaiyasate Kongkrit
Plastic and Reconstructive Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece.
Division of Plastic and Reconstructive Surgery, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, Royal Oak, Mich.
Plast Reconstr Surg Glob Open. 2020 Jul 23;8(7):e3003. doi: 10.1097/GOX.0000000000003003. eCollection 2020 Jul.
The area of nasal reconstruction can be challenging for the microsurgeon, as the nose is a complex structure. A 3-dimensional understanding of the organ is a prerequisite for a successful outcome. A combination of procedures is usually necessary to completely repair subtotal or total nasal defects. Contouring and secondary revisions may ensue to enhance the postoperative functional and aesthetic outcome of the reconstruction. This study aimed to present a review of the various methods of microvascular reconstruction for complex nasal defects based on the radial forearm flap (RFF).
Two independent reviewers screened the literature on PubMed according to the inclusion criteria. The keywords for the search were "microvascular," "nasal reconstruction," and "free flaps in nasal reconstruction." Articles on locoregional flap reconstruction, experimental animal studies, letters to the editors, non-English literature, and articles without full text were excluded from the study. The protocol is registered at the International Prospective Register of Systematic Reviews (CRD42019146447) under the umbrella of the National Institute for Health Research, and it is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
Eighteen eligible studies were included in our articles. The infolding RFF, multiple skin paddles RFF, and prelaminated RFF were described. The results have been more than encouraging so far. Also, 3 clinical cases where the RFF provided intranasal lining and a forehead flap resurfaced the nose were presented.
The RFF is a reliable technique for nasal reconstruction in expert hands.
由于鼻子结构复杂，鼻部重建区域对显微外科医生来说可能具有挑战性。对该器官的三维理解是取得成功结果的先决条件。通常需要联合多种手术来完全修复部分或全鼻缺损。可能需要进行轮廓塑造和二次修复，以提高重建术后的功能和美学效果。本研究旨在对基于桡侧前臂皮瓣（RFF）的复杂鼻缺损微血管重建的各种方法进行综述。
两名独立评审员根据纳入标准在PubMed上筛选文献。检索关键词为“微血管”“鼻重建”和“鼻重建中的游离皮瓣”。局部皮瓣重建、实验动物研究、给编辑的信、非英文文献以及无全文的文章均被排除在研究之外。该方案已在英国国家卫生研究院旗下的国际前瞻性系统评价注册库（CRD42019146447）注册，并按照系统评价和Meta分析的首选报告项目声明进行报告。
我们的文章纳入了18项符合条件研究。描述了内折式RFF、多皮肤瓣RFF和预构RFF。目前结果令人鼓舞。此外，还展示了3例RFF提供鼻内衬且前额皮瓣用于鼻表面重建的临床病例。
在专家手中，RFF是一种可靠的鼻重建技术。
