额部扩张皮瓣肋软骨支架植入鼻再造的临床研究  

Nasal reconstruction with forehead skin flap and costal cartilage frame

作　　者：张家建[1] 蔡震[1] 游晓波[1] 傅荣[1] 

机构地区：[1]四川省医学科学院.四川省人民医院整形外科,四川成都610072

出　　处：《四川医学》2013年第2期170-171,共2页Sichuan Medical Journal

摘　　要：目的探讨额部扩张皮瓣复合肋软骨支架移植鼻再造术的效果。方法额部帽状腱膜下埋置200ml皮肤软组织扩张器,扩张满意后,以滑车上动静脉为血管蒂设计三叶状皮瓣,取右侧第7或8肋软骨,雕刻成"L"型和倒"V"型复合鼻支架植入,皮瓣转移重建再造鼻,三期行断蒂及再造鼻修整手术。结果该手术行鼻再造修复12例,额部扩张皮瓣与移植软骨支架全部完全成活,再造鼻外形与鼻孔通气功能良好,随访一年以上,皮瓣无明显回缩,额部供皮区切口线性瘢痕小,患者满意。结论该方法对于鼻缺损患者,治疗后再造鼻形态满意,设计简便,安全可靠,是一种理想的手术方法。Objective To explore the effect of nasal reconstruction with expanded forehead flap and costal cartilage frame.Methods A skin soft tissue expander was placed under aponeurosis of occipitofron talis muscle on forehead.Trilobe flap with lateral supratrochlear artery was designed after enough dilated,seventh or eighth right costal cartilage was cut out,and carved into nasal frame,expanded forehead flap was transfered and reconstructed into nose.Cut off pedicle and reconstructed nose chipping were performed in third stage.Results 12 cases were performed by this method.expanded forehead flap and costal cartilage frame were all survived,shapes of reconstructed nose were good and ventilation function of nostril were normal.After more than 12 months follow-up,no recovery on flap and little scar in incision.All patients were satisfied with the postoperative results.Conclusion It is the preferred method for the repair of total nasal defect with expanded forehead flap and costal cartilage frame.We could obtain good shape in reconstructed nose.The method of pedicle flap transfer is safe and convenient in design and operation.

关 键 词：鼻再造 额部扩张皮瓣 肋软骨 支架 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]