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亚洲患者鼻再造的实用方法。

A practical approach to nasal reconstruction in Asian patients.

作者信息

Koh In Suk, Sun Hook

机构信息

Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea.

出版信息

Arch Craniofac Surg. 2021 Oct;22(5):268-275. doi: 10.7181/acfs.2021.00465. Epub 2021 Oct 20.

Abstract

BACKGROUND

The study aimed to evaluate nasal reconstruction techniques customized for Asians. The currently available nasal reconstruction guidelines are based on Caucasian patients, and their applicability is limited in Asian patients due to differences in anatomical and structural features.

METHODS

A retrospective analysis was performed of the medical records of 76 patients who underwent nasal reconstruction at a single center between January 2010 and June 2020. A comprehensive evaluation was conducted of patients' baseline demographics and clinical characteristics, including age, sex, medical history, defect size and location, reconstructive procedure, pathological diagnosis, postoperative complications, and recurrence.

RESULTS

In 59 cases (77%), nasal defects resulted from tumor ablation, and the remaining 17 cases involved post-traumatic (20%) and infection-induced (3%) tissue damage. The most common defect location was the alae, followed by the sidewalls, tip, and dorsum. Forehead flaps were the most commonly used reconstructive technique, followed by nasolabial advancement flaps, rotation flaps, and skin grafts. Each procedure was applied considering aspects of structural anatomy and healing physiology specific to Asians. Complications included nasal deformity, hypertrophic scarring, secondary infection, and partial flap necrosis, but no cases required additional surgical procedures. Tumors recurred in two cases, but tumor recurrence did not significantly affect flap integrity.

CONCLUSION

Nasal reconstruction techniques applied considering Asians' facial features resulted in fewer postoperative complications and higher patient satisfaction than the approaches that are currently in widespread use. Therefore, this study is expected to serve as an essential reference for establishing treatment guidelines for nasal reconstruction in Asians.

摘要

背景

本研究旨在评估为亚洲人定制的鼻再造技术。目前可用的鼻再造指南是基于白种人患者制定的,由于解剖结构特征的差异,其在亚洲患者中的适用性有限。

方法

对2010年1月至2020年6月在单一中心接受鼻再造手术的76例患者的病历进行回顾性分析。对患者的基线人口统计学和临床特征进行了全面评估,包括年龄、性别、病史、缺损大小和位置、重建手术、病理诊断、术后并发症和复发情况。

结果

59例(77%)鼻缺损由肿瘤切除引起,其余17例涉及创伤后(20%)和感染引起(3%)的组织损伤。最常见的缺损部位是鼻翼,其次是鼻侧壁、鼻尖和鼻背。额部皮瓣是最常用的重建技术,其次是鼻唇推进皮瓣、旋转皮瓣和植皮。每种手术都根据亚洲人特有的结构解剖和愈合生理方面进行应用。并发症包括鼻畸形、瘢痕增生、继发感染和部分皮瓣坏死,但无一例需要再次手术。2例出现肿瘤复发,但肿瘤复发并未显著影响皮瓣完整性。

结论

与目前广泛使用的方法相比,考虑亚洲人面部特征应用的鼻再造技术术后并发症更少,患者满意度更高。因此,本研究有望为制定亚洲人鼻再造治疗指南提供重要参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb3/8568497/2cbc773b42fd/acfs-2021-00465f1.jpg

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