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采用鼻唇沟皮瓣插入法重建鼻小柱:1例报告。

Reconstruction of the columella with interposition of nasogenian flaps: A case report.

作者信息

Faenza M, Molle M, Mazzarella V, Crisci E, Pieretti G, Nicoletti M M

机构信息

Plastic and Reconstructive Surgery Unit, University of Campania, Naples, Italy.

Plastic and Reconstructive Surgery Unit, University of Campania, Naples, Italy.

出版信息

Int J Surg Case Rep. 2024 Feb;115:109238. doi: 10.1016/j.ijscr.2024.109238. Epub 2024 Jan 15.

Abstract

INTRODUCTION

Reconstructing large defects of the columella and upper lip is an interesting challenge in facial reconstruction due to the high visibility of this aesthetic subunit and the difficulties posed by the unique characteristics of the skin in these areas, which differs from that of the surrounding regions. Among the various techniques proposed, the use of local flaps remains the most commonly used and effective method in this type of reconstruction.

PRESENTATION OF THE CASE

A 47-year-old man in good clinical condition presented with a nodular lesion on the columella and upper lip. The lesion was excised (revealing it to be a squamous cell carcinoma) and reconstructed using two opposing nasogenian flaps, resulting in an optimal aesthetic and functional restoration.

DISCUSSION

The use of local flaps remains the most effective technique for columella defect reconstruction. However, many described techniques require multiple surgical stages or result in visible scarring. Additionally, they do not guarantee effective reconstruction in cases involving the upper lip. On the other hand, the use of free flaps, while more expensive and requiring expert teams, may not ensure optimal color and skin texture matching.

CONCLUSIONS

The use of opposing nasogenian flaps allows for a rapid and effective reconstruction of defects involving the columella and upper lip, leading to a swift return to normal life for the patient.

摘要

引言

由于鼻小柱和上唇这一美学亚单位的高可见性以及这些区域皮肤的独特特征(与周围区域不同)所带来的困难,重建鼻小柱和上唇的大缺损在面部重建中是一项具有挑战性的有趣任务。在提出的各种技术中,使用局部皮瓣仍然是这类重建中最常用且有效的方法。

病例介绍

一名临床状况良好的47岁男性,鼻小柱和上唇出现结节性病变。病变被切除(显示为鳞状细胞癌),并使用两个相对的鼻唇沟皮瓣进行重建,实现了最佳的美学和功能恢复。

讨论

使用局部皮瓣仍然是鼻小柱缺损重建最有效的技术。然而,许多已描述的技术需要多个手术阶段或会导致明显的瘢痕形成。此外,在涉及上唇的病例中,它们不能保证有效的重建。另一方面,使用游离皮瓣虽然更昂贵且需要专业团队,但可能无法确保最佳的颜色和皮肤质地匹配。

结论

使用相对的鼻唇沟皮瓣能够快速有效地重建涉及鼻小柱和上唇的缺损,使患者迅速恢复正常生活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b638/10828049/94b81dbbe5de/gr1.jpg

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