Nahai Farzad R, Papadopoulos Diamondis J, Papadopoulos John Paul, Thatos Paris, Manalo Iviensan F
From the The Center for Plastic Surgery at MetroDerm.
MetroDerm, PC, Atlanta, GA.
Ann Plast Surg. 2021 Feb 1;86(2):171-174. doi: 10.1097/SAP.0000000000002621.
Nasal reconstruction after Mohs resection of skin cancer commonly uses local flaps, many of which present limitations concerning their movement and skin color/texture match. In this article, the use of a myocutaneous island pedicle flap based on the nasalis muscle with bilevel undermining for the management of defects at challenging locations on the nose is described as a versatile and cosmetically appropriate flap option. In addition, a novel mathematical sizing methodology for this flap is presented.
Between March 2013 and May 2016, 57 patients having undergone Mohs resection of skin cancer underwent nasal reconstruction using a myocutaneous island pedicle flap based on the nasalis muscle with bilevel undermining at our clinic. During the postoperative follow-up, patients were monitored for complications and received proper wound care.
The mean age was 68.4 (range, 34-94) years. The mean follow-up was 10.1 (range, 3.0-34.9) months. The mean defect size was 1.99 (range, 0.70-5.25) cm2. No complete losses of flap occurred. Incidence of minor complications (pin cushion effect, minor delayed healing, etc) was minimal (4/57; 7.0%). Two of the cases in this series involved the utilization of cartilage grafts in combination with the myocutaneus island pedicle flap.
The myocutaneous island pedicle flap based on the nasalis muscle with bilevel undermining can be used as a versatile flap for the closure of defects of various sizes and locations on the nose because of its rich blood supply, ease and convenience of use, and highly acceptable cosmetic outcome.
皮肤癌莫氏切除术后的鼻再造通常使用局部皮瓣，其中许多皮瓣在移动性以及皮肤颜色/质地匹配方面存在局限性。在本文中，描述了一种基于鼻肌的肌皮岛状蒂皮瓣，采用双层剥离法用于处理鼻上具有挑战性部位的缺损，该皮瓣是一种通用且在美容方面合适的皮瓣选择。此外，还介绍了一种针对该皮瓣的新型数学测量方法。
2013年3月至2016年5月期间，57例接受皮肤癌莫氏切除术的患者在我们诊所接受了基于鼻肌的肌皮岛状蒂皮瓣双层剥离法鼻再造术。术后随访期间，对患者进行并发症监测并给予适当的伤口护理。
平均年龄为68.4岁（范围34 - 94岁）。平均随访时间为10.1个月（范围3.0 - 34.9个月）。平均缺损面积为1.99平方厘米（范围0.70 - 5.25平方厘米）。未发生皮瓣完全坏死。轻微并发症（针垫效应、轻度延迟愈合等）的发生率极低（4/57；7.0%）。本系列中有2例病例涉及将软骨移植与肌皮岛状蒂皮瓣联合使用。
基于鼻肌的双层剥离肌皮岛状蒂皮瓣因其血供丰富、使用简便且美容效果高度可接受，可作为一种通用皮瓣用于闭合鼻上各种大小和部位的缺损。
