The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Plast Reconstr Aesthet Surg. 2023 Aug;83:109-116. doi: 10.1016/j.bjps.2023.04.005. Epub 2023 Apr 17.
The expanded forehead flap has its unique advantage in nasal reconstruction. The authors present their 12-year experience with nasal reconstruction with an expanded forehead flap. The esthetic and functional outcomes were assessed with long-term subjective and objective evaluations.
A retrospective analysis was conducted of consecutive patients who underwent nasal reconstruction with the expanded forehead flap from 2009 to 2021 performed by the senior author (F.F.). Data were collected and analyzed regarding defect characteristics, processes of treatment, and complications. Subjective esthetic and functional outcomes were assessed through questionnaires FACE-Q (Face Questionnaire) and NOSE (Nasal Obstruction Symptom Evaluation). The objective esthetic outcome was assessed by a senior resident through the viewing of clinical photographs.
One hundred and fifty-five patients underwent nasal reconstruction with an expanded forehead flap. The average expansion period was 174 days, and the injection volume was 685.7 ml. There were 15 complications. One hundred and eight patients (69.6%) were satisfied, and 19 patients (12.2%) were very satisfied with the outcome. The differences between postoperative and preoperative scores of FACE-Q were statistically significant (p < 0.01). Sixty-nine percent of patients complained of bilateral eyebrow asymmetry, 27.1% of patients reported partial recovery of frontal deformity with dissatisfaction, and 2.6% of patients considered not recovered at all. The results of 78 patients (50.3%) were considered "satisfied," and 41 patients (26.5%) were considered "very satisfied" by objective evaluation.
Nasal reconstruction with an expanded forehead flap was a safe technique with good esthetic outcomes. Although problems with the asymmetry of the eyebrows and frontal deformation were presented, the influence was minimal and well-accepted by most patients.
扩张额瓣在鼻重建中具有独特的优势。作者介绍了他们在 12 年期间使用扩张额瓣进行鼻重建的经验。通过长期的主观和客观评估来评估美学和功能结果。
对 2009 年至 2021 年由资深作者（FF）进行的使用扩张额瓣进行鼻重建的连续患者进行了回顾性分析。收集并分析了有关缺陷特征、治疗过程和并发症的数据。通过 FACE-Q（面部问卷）和 NOSE（鼻阻塞症状评估）问卷调查评估主观美学和功能结果。通过资深住院医师查看临床照片评估客观美学结果。
155 例患者接受了扩张额瓣鼻重建。平均扩张期为 174 天，注射量为 685.7ml。有 15 个并发症。108 例（69.6%）患者对结果满意，19 例（12.2%）患者非常满意。FACE-Q 术后和术前评分之间的差异具有统计学意义（p<0.01）。69%的患者抱怨双侧眉毛不对称，27.1%的患者报告部分恢复额部畸形不满意，2.6%的患者认为根本没有恢复。78 例（50.3%）患者的结果被认为“满意”，41 例（26.5%）患者的结果被认为“非常满意”。
使用扩张额瓣进行鼻重建是一种安全的技术，具有良好的美学效果。尽管存在眉毛不对称和额部畸形的问题，但影响很小，大多数患者都能接受。
