鼻唇沟折叠穿支皮瓣修复鼻翼全层缺损  

Clinical application of the nasolabial fold wrapped perforator flap in repairing pinna nasi defect

作　　者：吴晓勇[1] 熊猛[2] 

机构地区：[1]东南大学附属江阴医院整形美容科,214400 [2]东南大学附属中大医院整形科

出　　处：《中华医学美学美容杂志》2014年第5期321-323,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的 探讨鼻唇沟折叠穿支皮瓣一次性修复鼻翼缺损达到形态较为完美的可行性.方法 用鼻唇沟折叠穿支皮瓣共修复鼻翼缺损10例.术前探测鼻唇沟区血管分布以及该区域血管穿支浅出点,按照缺损的区域和大小设计鼻唇沟折叠穿支皮瓣,根据缺损修复要求修剪皮瓣,使皮瓣最终成为厚薄适宜、可同时折叠修复皮外被皮肤和形成衬里的局部皮瓣,旋转转移修复鼻翼缺损.结果 10例患者皮瓣全部存活,术后随访4个月至2年,瘢痕不明显,鼻翼修复形态满意,无臃肿,保留神经皮支患者,修复鼻翼感觉良好,患者较为满意.结论 鼻唇沟折叠穿支皮瓣具有血供可靠、蒂长转移范围大、修复区域广、皮瓣厚薄适宜、外在皮肤与衬里同时修复的优点,修复后鼻翼形态满意,避免了因术后皮瓣臃肿需行Ⅱ期修复之弊,并保留了外鼻的感觉功能.鼻唇沟折叠穿支皮瓣是修复鼻翼全层缺损较为理想的方法.Objective To explore the feasibility of nasolabial fold wrapped perforator flap in repairing pinna defects to produce the relative perfect appearance.Methods We treated 10 cases of pinna nasi defects by the nasolabial fold wrapped perforator flap.We examined the blood vessel distribution and exit of the blood vessel before surgery,and designed the nasolabial fold wrapped perforator flap according to the pinna defects.The flap with reasonable thickness was able to repair the both sides of defect after being cut properly.Meanwhile,the flap could be folded to form a local flap covered or lined with skin,and rotately transfered to repair nasal alar defect.Results All the flaps survived with incisions of donor sites healed primarily.Following up for 4 to 24 months showed that the color,texture and thickness of the flaps were similar to those of recipient sites.The scar in donor site was concealed and not obvious.Those cases who kept neurocutaneous branch had good sense.Satisfactory appearance was received without secondary repair.Conclusions The nasolabial fold wrapped perforator flap has abundant blood circulation and easily survives.It can also afford ample tissues to repair major area of pinna nasi defects,The blood vessel peduncle is too long to be survived easily.And the donor has not clear scar.Second reconstruction can be avoided in this procedure.The nasolabial fold wrapped perforator flap is one of the best choices to repair pinna defects.

关 键 词：鼻唇沟 皮瓣 鼻翼缺损 

分 类 号：R765.9[医药卫生—耳鼻咽喉科] R62[医药卫生—临床医学]