根据鼻部美容分区选择修复鼻翼缺损方法  

Selection of appropriate method to repair the defect of ala based on nasal aesthetic subunits

作　　者：马勇光[1] 李健宁[1] 秦荣生[1] 朱力[1] 陈育哲[1] 夏有辰[1] 王侠[1] 

机构地区：[1]北京大学第三医院成形外科,北京100083

出　　处：《中华医学美学美容杂志》2005年第4期212-214,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨东方人鼻部美容分区与鼻翼缺损修复手术方法选择的关系。方法如鼻翼缺损局限于鼻翼内2/3区域内,首选耳廓复合组织游离移植修复,在鼻翼创缘向内翻转局部皮瓣作为部分衬里;如缺损向内超过鼻翼区达鼻端区,向外超过鼻翼中外1/3交界,则首选同侧鼻唇沟真皮下血管网皮瓣修复。结果本组17例,其中11例选用耳廓复合组织游离移植,6例选择鼻唇沟真皮下血管网薄皮瓣行鼻翼修复。移植组织全部成活,鼻翼外形和色泽满意。结论依据鼻部美容分区选择手术,可使术后外形更加逼真,瘢痕更隐蔽。翻转局部皮瓣作为部分衬里可扩大移植物与受区的接触面积,提高成活率,并克服了直线瘢痕收缩形成鼻翼缘小缺口的不足。鼻唇沟真皮下血管网皮瓣血液循环可靠,再造鼻翼的臃肿程度大大减轻。Objective To study the relations between the nasal aesthetic subunits and the selection of the reparative methods on orientals. Methods If the defect is located on the medial 2/3 of the ala subunit, the auricular composite grafting should be the first choice with the turndown flap of nasal skin or scar as partial lining. If the defect reaches the nasal tip subunit medially or lateral 1/3 of the ala, the nasal labial thin skin flap with subdermal vascular plexus on the same side should be applied. Results 17 cases including 11 cases using auricular composite grafting and 6 cases with nasal labial thin skin flap with subdermal vascular plexus were reported. All the grafts or the flaps took or survived, and the postoperative contour and color were satisfactory. Conclusions Selecting the operation methods based on the aesthetic subunits makes the reconstructed contour of the ala more realistic and the scar more hidden. Turning down the flap increases the recipiem bed and making the “take” more easily, and overcomes the shortage of the notch deformity on the ala rim caused by the constriction of the direct line scar. The nasal labial thin skin flap with suhderrnal vascular plexus has reliable blood supply, and it makes the bulky repaired ala become thinner.

关 键 词：鼻翼缺损 美容分区 耳廓复合组织 鼻唇沟真皮下血管网皮瓣 鼻部美容 缺损修复 耳廓复合组织游离移植 真皮下血管网皮瓣修复 分区 真皮下血管网薄皮瓣 

分 类 号：R765.9[医药卫生—耳鼻咽喉科] R622[医药卫生—临床医学]