Krogerus Christina, Demant Mia, Lindskow Thomas, Hesselfeldt Jørgen
Department of Plastic Surgery and Breast Surgery, Zealand University Hospital, Roskilde, Denmark.
Department of Plastic Surgery and Breast Surgery, Zealand University Hospital, Roskilde, Denmark.
Int J Surg Case Rep. 2022 Jan;90:106694. doi: 10.1016/j.ijscr.2021.106694. Epub 2021 Dec 18.
The nose is a common location for non-melanoma skin cancers. Resection of such cancers can result in large, multilayer defects that are challenging to reconstruct. The surgical approach is determined by multiple factors and the main goal is to obtain a satisfactory functional and aesthetic result. We present a case of reconstruction of the nasal vestibuli and columella by two transnasal nasolabial flaps.
A 66-year-old male underwent resection of a large squamous cell carcinoma in the right nasal vestibulum that extended through the columella into the left vestibulum. The resection resulted in a multilayer defect including the floor and roof of the right vestibulum, the entire columella, part of the septum cartilage and floor of the left vestibulum. The defect was reconstructed in two stages by bilateral nasolabial flaps, that were brought into the nasal cavity through incisions on the side of the nose and were used to line the vestibuli and sutured to each other medially to form the neocolumella. No complications or surgical site infections were observed.
Transnasal nasolabial flaps can be used for larger columellar defects. The length of the flaps in our case provided enough tissue to reconstruct the columella as well as the entire vestibular linings.
We describe a successful reconstruction of the nasal vestibuli and columella with two transnasal nasolabial flaps, which provided an acceptable aesthetic and functional result.
鼻子是皮肤非黑色素瘤癌的常见发病部位。此类癌症切除后可能导致大面积的多层缺损，修复起来具有挑战性。手术方式由多种因素决定，主要目标是获得满意的功能和美学效果。我们报告一例采用双侧经鼻鼻唇瓣修复鼻前庭和鼻小柱的病例。
一名66岁男性接受了右侧鼻前庭大鳞状细胞癌切除术，该肿瘤延伸穿过鼻小柱至左侧前庭。切除术后造成了多层缺损，包括右侧前庭的底部和顶部、整个鼻小柱、部分鼻中隔软骨以及左侧前庭底部。通过双侧鼻唇瓣分两期修复缺损，鼻唇瓣经鼻侧切口进入鼻腔，用于衬里前庭，并在内侧相互缝合形成新鼻小柱。未观察到并发症或手术部位感染。
经鼻鼻唇瓣可用于修复较大的鼻小柱缺损。我们病例中皮瓣的长度提供了足够的组织来修复鼻小柱以及整个前庭衬里。
我们描述了一例采用双侧经鼻鼻唇瓣成功修复鼻前庭和鼻小柱的病例，获得了可接受的美学和功能效果。
