Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
J Craniofac Surg. 2021;32(8):e719-e724. doi: 10.1097/SCS.0000000000007703.
The reconstruction of nasal alar defects after resection of a melanocytic nevus becomes one of the most challenging procedures for surgeons. Choosing the most appropriate technique is still difficult sometimes. The authors reviewed our cases and published experience on choosing optimal surgical methods to repair different types of nasal alar defect following melanocytic nevus resection.
A total of 152 patients who were treated between 2016 and 2019 in Shanghai Ninth People's Hospital were evaluated. The surgical methods included primary closure, full-thickness skin graft, composite auricular graft, interpolated melolabial flap, paramedian forehead flap including hair-bearing paramedian forehead flap.
Among the 152 patients with a melanocytic nevus, 49 underwent primary closure, 38 were treated with a full-thickness skin graft, 16 composite auricular graft, 28 were treated with interpolated melolabial flap, and 21were treated with paramedian forehead flap including 14 with hair-bearing paramedian forehead flap. Most skin graft, composite auricular graft, and flaps were survived. Patients who completed follow-up were satisfied with the contour of the nasal ala.
After resection of the melanocytic nevus, the surgeon should choose the most appropriate surgical method for alar reconstruction according to the characteristics of the defect and personal desire of patient or the guardian.
切除黑素细胞痣后重建鼻翼缺损是外科医生面临的最具挑战性的手术之一。有时,选择最合适的技术仍然很困难。作者回顾了我们的病例,并发表了关于选择最佳手术方法修复黑素细胞痣切除后不同类型鼻翼缺损的经验。
评估了 2016 年至 2019 年期间在上海第九人民医院治疗的 152 例患者。手术方法包括直接缝合、全厚皮片移植、复合耳郭移植、交叉唇瓣、包括带发中前额皮瓣的正中前额皮瓣。
在 152 例黑素细胞痣患者中,49 例行直接缝合,38 例行全厚皮片移植,16 例行复合耳郭移植,28 例行交叉唇瓣,21 例行包括 14 例带发中前额皮瓣的正中前额皮瓣。大多数皮片、复合耳郭和皮瓣均存活。完成随访的患者对鼻翼外形满意。
切除黑素细胞痣后,外科医生应根据缺损的特点和患者或监护人的个人意愿选择最合适的鼻翼重建手术方法。