Brambullo Tito, Franchi Arianna, Masciopinto Giuseppe, De Lazzari Alberto, Vindigni Vincenzo, Bassetto Franco
Plastic Surgery Unit, Department of Neurosciences, School of Medicine and Surgery, University of Padua, Padua, Italy.
Front Surg. 2024 Aug 9;11:1420673. doi: 10.3389/fsurg.2024.1420673. eCollection 2024.
The forehead flap is probably the most used method for nose reconstruction after cancer resection. During the past century, this technique has been continuously refined to achieve better functional and aesthetic outcomes. Different variations have been described, with the original technique being modified based on tissue loss, the layer to be replaced, and the management of the donor area.
We propose a new and innovative version of the forehead flap in which both the forehead skin and the frontal muscle are harvested simultaneously using the same vascular pedicle. Partially separating the two layers allows muscle tissue to replace the inner layer and cover the nasal septum framework, while the skin will replace the outer layer. The nostrils are reconstructed simultaneously using bilateral hinge-over lining skin flaps harvested from the nasal folds.
Step by step, a schematic illustration of the technique is given, followed by a complete report on a successful total nose reconstruction case.
Despite the increasing number of techniques which have been introduced to achieve full reconstruction of the nose, including microsurgical tissue transfer, the simultaneous replacement of both the inner and outer layers continues to be an issue for the plastic surgeon. In this article, we suggest a solution for total nose reconstruction in a single-stage procedure.
前额皮瓣可能是癌症切除术后鼻再造最常用的方法。在过去的一个世纪里，这项技术不断改进以获得更好的功能和美学效果。已经描述了不同的变体，原始技术根据组织缺损、要替换的层次以及供区处理进行了改良。
我们提出了一种新型创新的前额皮瓣，其中前额皮肤和额肌使用同一血管蒂同时切取。将两层部分分离可使肌肉组织替代内层并覆盖鼻中隔框架，而皮肤则替代外层。使用从鼻褶处切取的双侧翻转衬里皮瓣同时重建鼻孔。
逐步给出了该技术的示意图，随后是一例成功的全鼻再造病例的完整报告。
尽管为实现全鼻再造引入了越来越多的技术，包括显微外科组织移植，但同时替换内层和外层仍然是整形外科医生面临的一个问题。在本文中，我们提出了一种一期全鼻再造的解决方案。
