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[不同修复方法在外鼻恶性肿瘤Mohs显微外科手术后缺损修复中的应用]

[Application of different repair methods for defects after Mohs micrographic surgery for malignant tumors of the external nose].

作者信息

Li Huilin, Zheng Mei, Wang Xiaolin, Qi Huan, Zhang Zhifei

机构信息

Department of Otolaryngology Head and Neck Surgery,Kashi Prefecture Second Peoples Hospital,Kashi,844000,China.

Anesthesia Surgery Center,Kashi Prefecture Second Peoples Hospital.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Sep;39(9):830-835. doi: 10.13201/j.issn.2096-7993.2025.09.006.

Abstract

To observe the effects of different repair methods in the defects after Mohs surgical excision of malignant nasal tumors. Twenty-two cases of external nasal malignant tumor surgery from January 2021 to May 2024 were selected as the research. The tumors were resected using Mohs surgical technique, and the defects were repaired using forehead axial flap, bipedicle flap, nasolabial flap, free full-thickness skin graft from the groin, forehead axial flap, facial kite flap, and composite flap of earlobe cartilage and perichond. The postoperative flap survival, external nasal morphology, and tumor recurrence were observed. Among the 22 cases, there were 1 case of Kaposis sarcoma(KS), 2 cases of squ cell carcinoma, and 19 cases of basal cell carcinoma. Tumors were located at the nasal root in 3 cases, the nasal dorsum in5 cases, the nasal tip in 2 cases, the ala in 8 cases, both the ala and the nasal dorsum in 2 cases, nasal columella, the nasal tip, and the ala in 1 case, the nasal tip, the nasal dorsum, the ala, and paranasal area in 1 case. The size of the defects ranged from 1.2 cm×1.4 cm to 3.7 cm×4.8 cm. Three cases were repaired with forehead axial flaps, four cases with bilobed flaps, thirteen cases with nasolabial groove flaps, one case with free full-thickness skin grafts from the inguinal region, and one case with a combination of forehead axial flaps and facial kite flaps plus a composite of earlobe cartilage and perichondrium. All flaps survived well after surgery. Patients were followed up for 6 months to 3 years after surgery, during which no tumor recurrence was observed, and most patients were satisfied with appearance of their nose. Mohs surgery is used to excise the malignant tumor of the external nose, and satisfactory surgical results can be obtained by using different repair methods based the location and size of the postoperative defect.

摘要

观察不同修复方法对鼻部恶性肿瘤Mohs手术切除后缺损的修复效果。选取2021年1月至2024年5月行外鼻恶性肿瘤手术的22例患者作为研究对象。采用Mohs手术技术切除肿瘤,术后缺损分别采用额部轴型皮瓣、双叶皮瓣、鼻唇沟皮瓣、腹股沟区全厚皮片游离移植、额部轴型皮瓣、面部风筝皮瓣以及耳垂软骨与软骨膜复合瓣修复。观察术后皮瓣存活情况、外鼻形态及肿瘤复发情况。22例患者中,卡波西肉瘤(KS)1例,鳞状细胞癌2例,基底细胞癌19例。肿瘤位于鼻根3例,鼻背5例,鼻尖2例,鼻翼8例,鼻翼及鼻背2例,鼻小柱、鼻尖及鼻翼1例,鼻尖、鼻背、鼻翼及鼻旁区1例。缺损面积为1.2 cm×1.4 cm至3.7 cm×4.8 cm。3例采用额部轴型皮瓣修复,4例采用双叶皮瓣修复,13例采用鼻唇沟皮瓣修复,1例采用腹股沟区全厚皮片游离移植修复,1例采用额部轴型皮瓣联合面部风筝皮瓣及耳垂软骨与软骨膜复合瓣修复。术后所有皮瓣均存活良好。术后随访6个月至3年,均未观察到肿瘤复发,多数患者对鼻部外观满意。Mohs手术用于切除外鼻恶性肿瘤,根据术后缺损部位及大小采用不同修复方法可获得满意的手术效果。

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