以鼻部SMAS为蒂的V-Y形鼻肌肌皮瓣修复鼻部皮肤缺损的临床观察  

Clinical observation of V-Y shaped nasal musculocutaneous flap pedicled with superficial musculoaponeurotic system （SMAS） for nasal defect reconstruction

作　　者：王文津[1] 徐苗[1] 杨超[1] 毕宏达[1] 邢新[1] 

机构地区：[1]第二军医大学附属长海医院整形外科,上海200433

出　　处：《中国美容整形外科杂志》2015年第2期98-101,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 介绍一种修复鼻部皮肤软组织缺损的新方法.方法 根据缺损位置和面积,沿近侧鼻翼沟和鼻唇沟设计V-Y形鼻肌肌皮瓣,于软骨膜表面切取皮瓣,并解剖其上方宽广的表浅鼻肌腱膜组织作为单侧蒂,旋转推进覆盖创面.结果 共修复多种原因所致的鼻部皮肤软组织缺损20例,其中鼻背6例,鼻尖5例,鼻尖-鼻背交界处9例;缺损面积0.8 cm×0.8 cm～2.0 cm ×2.2 cm.所有肌皮瓣均完全存活,随访3～12个月,患者对鼻部外观及功能满意.结论 以鼻部表浅肌肉腱膜系统为蒂的V-Y形鼻肌肌皮瓣,能够修复中等大小的鼻部缺损,其设计简单,血供可靠,转移方便,修复效果满意,值得推广应用.Objective To introduce a new method for the repair of the nasal defects with V-Y shaped nasal musculocutaneous flap pedicled with superficial musculoaponeurotic system （SMAS）. Methods According to the location and size of the nasal defects, a V-Y shaped nasal museulocutaneous flap was designed along the proximal alar groove and nasolabial fold and harvested on the surface of periehondrium and the superficial nasal musculoaponeurotic system （SMAS） above the flap was dissected as the unilateral pedicle. The flap was rotated and advanced to cover the defect. Results Twenty cases with nasal defects ranged from 0.8 cm × 0.8 cm to 2.0 cm × 2.2 cm, including 6 nasal dorsums, 5 nasal tips and 9 nasal tip-dorsum junctions, were reconstructed with this method. All flaps survived primarily and 20 patients were followed up for 3 to 12 months postoperatively, all were satisfied with contour and functions without any complications. Conclusion Application of the V-Y shaped nasal musculocutaneous flaps pedicled with nasal SMAS is appropriate for the reconstruc- tion of small to medium nasal defects which can achieve a satisfactory resuh with a simple design, convenient transfer, reliable blood and concealed incision.

关 键 词：鼻肌腱膜系统 鼻肌肌皮瓣 V-Y推进 鼻部缺损 

分 类 号：R622[医药卫生—整形外科]