All authors are affiliated with the Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Dermatol Surg. 2021 May 1;47(5):618-622. doi: 10.1097/DSS.0000000000002895.
Reconstructing defects on the nose can be challenging. The bilobed transposition flap and the nasalis-based V to Y (NBVY) flaps can be excellent repair options, each with their own advantages and disadvantages.
To compare bilobed and NBVY flap scar appearances, postoperative complications, scar revision rates, flap sizes, and relative costs.
We reviewed 95 cases of Mohs surgery defects on the nose repaired with either a bilobed or a NBVY flap from 2010 to 2018 at our institution. Eleven reviewers judged postoperative scar images using a modified visual analog scale.
There were no significant differences in reviewer-rated scar appearances, complication rates, or revision rates between bilobed and NBVY flaps. The NBVY flaps were 50% smaller than bilobed flaps, with significantly lower CPT billing codes. The NBVY flaps yielded better scar appearance scores compared with bilobed flaps on highly sebaceous noses.
The NBVY and bilobed flaps demonstrated similar scar appearance outcomes, but the NBVY flap has several advantages. Compared with the bilobed flap, the NBVY flap is smaller, less expensive, and may yield better cosmetic outcomes in patients with highly sebaceous noses.
重建鼻部缺损具有挑战性。双叶旋转皮瓣和鼻侧 V 到 Y（NBVY）皮瓣都是极好的修复选择，各有优缺点。
比较双叶皮瓣和 NBVY 皮瓣的瘢痕外观、术后并发症、瘢痕修正率、皮瓣大小和相对费用。
我们回顾了 2010 年至 2018 年在我院采用双叶皮瓣或 NBVY 皮瓣修复的 95 例 Mohs 手术鼻部缺损病例。11 名评审员使用改良视觉模拟评分法对术后瘢痕图像进行了评估。
双叶皮瓣和 NBVY 皮瓣在瘢痕外观、并发症发生率或修正率方面无显著差异。与双叶皮瓣相比，NBVY 皮瓣小 50%，CPT 计费码明显更低。与双叶皮瓣相比，NBVY 皮瓣在皮脂分泌旺盛的鼻部获得了更好的瘢痕外观评分。
NBVY 皮瓣和双叶皮瓣在瘢痕外观结果方面相似，但 NBVY 皮瓣具有几个优势。与双叶皮瓣相比，NBVY 皮瓣更小、更经济，并且在皮脂分泌旺盛的患者中可能获得更好的美容效果。
