Peters Florian, Mücke Matthias, Möhlhenrich Stephan Christian, Bock Anna, Stromps Jan-Philipp, Kniha Kristian, Hölzle Frank, Modabber Ali
Department of Oral, Maxillofacial and Facial Plastic Surgery, School of Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Department of Oral, Maxillofacial and Facial Plastic Surgery, School of Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
J Plast Reconstr Aesthet Surg. 2021 Apr;74(4):740-746. doi: 10.1016/j.bjps.2020.10.009. Epub 2020 Oct 24.
The incidence of skin cancer, which often affects the facial skin, has risen worldwide. After resecting such facial lesions, plastic reconstruction is necessary in most cases. The paramedian forehead flap (PFF) and the bilobed flap (BF) are commonly used for nasal reconstruction, but whether patients and physicians are satisfied with the esthetics is undetermined? In this study, scar questionnaires (Manchester Scar Scale, Vancouver Scar Scale, and Patient and Observer Scar Assessment Scale) and optical three-dimensional (3D) imaging were used for subjective and objective evaluation of esthetical outcomes after plastic reconstruction of the nose in 30 patients. The distances between landmarks and changes in volume between the treated and both the mirrored, healthy side of the face as well as an untreated, matched control group were measured using the optical (3D) scans. The questionnaires ascertained whether the patient was content with the esthetical outcome of both flaps. In the opinion of the observer, the esthetical outcome of both flaps was sufficient; only a few of the measured distances differed significantly between the patients and the control group. However, the measured volume differences of the donor site of the flap differed significantly between the PFF group and the control group (p = 0.0078). The BF was used for smaller defects, while the PFF was used for major defects. Besides a greater donor-side morbidity for the PFF, both flaps led to esthetically sufficient results and could be used for the reconstruction of the nose depending on the defect size and localization.
皮肤癌的发病率在全球范围内呈上升趋势，且常累及面部皮肤。切除此类面部病变后，多数情况下需要进行整形重建。正中旁前额皮瓣（PFF）和双叶皮瓣（BF）常用于鼻再造，但患者和医生对其美学效果是否满意尚无定论。在本研究中，采用瘢痕调查问卷（曼彻斯特瘢痕量表、温哥华瘢痕量表以及患者和观察者瘢痕评估量表）和光学三维（3D）成像对30例患者鼻整形重建后的美学效果进行主观和客观评估。利用光学（3D）扫描测量治疗部位与面部镜像健康侧以及未治疗的匹配对照组之间的标志点距离和体积变化。调查问卷确定患者对两种皮瓣的美学效果是否满意。观察者认为，两种皮瓣的美学效果均足够；患者与对照组之间仅少数测量距离存在显著差异。然而，皮瓣供区的测量体积差异在PFF组和对照组之间存在显著差异（p = 0.0078）。BF用于较小的缺损，而PFF用于较大的缺损。除了PFF供区的发病率较高外，两种皮瓣均能产生美学上足够的效果，可根据缺损大小和位置用于鼻再造。
