Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Canada.
Faculty of Medicine, Dalhousie University, Halifax, Canada.
J Laryngol Otol. 2023 May;137(5):532-536. doi: 10.1017/S0022215122000937. Epub 2022 Apr 6.
Effective nasal reconstruction requires skin and soft tissue cover, cartilage or bone structure, and mucosal lining. Ideal lining is thin, pliable and vascularised, making reconstruction challenging. This paper presents the first case series with long-term outcomes of pericranial flaps used as inner lining for nasal reconstruction.
Patients undergoing paramedial forehead flaps from 2007 to 2019 were identified using second-stage nasal reconstruction billing codes. Patients with pericranial flaps for lining, for whom there were data on resulting outcomes and complications, were identified.
Sixty-six patients underwent second-stage nasal reconstruction. Eighteen patients had paramedian forehead and pericranial flaps for inner lining reconstruction. The flap lining had no immediate post-operative complications. Three patients suffered partial to major reconstructive failure post radiotherapy. Other complications included nasal stenosis and orocutaneous fistula.
Combined with paramedian forehead flaps, the pericranial flap is reliable as inner lining for nasal reconstruction. It is easily accessible and useful in resections with limited mucosal options.
有效的鼻腔重建需要皮肤和软组织覆盖、软骨或骨结构以及黏膜衬里。理想的衬里应该是薄的、柔韧的和血管化的，这使得重建具有挑战性。本文介绍了首例采用颅顶筋膜瓣作为鼻腔重建内层的病例系列，并报告了其长期结果。
使用二期鼻重建计费代码，确定了 2007 年至 2019 年间接受正中额瓣的患者。确定了采用颅顶筋膜瓣作为内层的患者，并记录了其结果和并发症的数据。
66 例患者接受了二期鼻重建。18 例患者采用正中额瓣和颅顶筋膜瓣进行内层重建。皮瓣衬里术后即刻无并发症。3 例患者在放疗后出现部分至完全重建失败。其他并发症包括鼻狭窄和口-鼻瘘。
颅顶筋膜瓣与正中额瓣联合应用，是一种可靠的鼻腔重建内层。它易于获取，在黏膜选择有限的切除术中非常有用。
