鼻唇折叠皮瓣在外鼻肿瘤切除后全层缺损Ⅰ期修复中的应用  

Application of nasolabial fold wrapped perforator flap in one-stage repair of nasal alar full-thickness defects after tumor resection

作　　者：颜丙会[1] 张烽[2] 王志颐[1] 张勇[1] 陈伟[1] 许莉[1] 江满杰[1] 

机构地区：[1]南京军区南京总医院耳鼻咽喉头颈外科,南京210002 [2]南通市第三人民医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第9期655-656,663,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：江苏省基础研究项目(No:bk20161388)

摘　　要：目的:探讨鼻唇折叠皮瓣在外鼻肿瘤切除后鼻翼全层缺损Ⅰ期修复中的应用。方法:外鼻肿瘤15例,肿瘤切除后鼻翼全层缺损,Ⅰ期用鼻唇尖端折叠皮瓣修复鼻翼缺损。术前探测鼻唇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尖端折叠皮瓣,根据缺损修复要求修剪皮瓣,使皮瓣最终成为厚薄适宜、鼻外被皮肤和鼻内衬里的局部皮瓣,旋转转移修复鼻翼全层缺损。结果:15例患者皮瓣全部存活,术后随访3个月~3年,瘢痕不明显,鼻翼修复形态满意,鼻腔内痂皮少,修复鼻翼感觉良好。结论:鼻唇折叠皮瓣具有血供好、蒂长、皮瓣厚度适宜、外被皮肤、内有衬里的优点,修复后鼻翼形态满意,鼻腔内干痂少,并保留了外鼻的感觉功能。鼻唇折叠皮瓣是外鼻肿瘤切除后鼻翼全层缺损Ⅰ期修复较为理想的方法。Objective：To explore the application of nasolabial fold wrapped perforator flap in one-stage repair of nasal alar full-thickness defects after external nasal tumor resection.Method：Fifteen csaes of alar full-thickness defects after external nasal tumor resection were repaired with the nasolabial fold wrapped perforator flaps in a one-stage procedure.We detected the blood vessel distribution and exit of the blood vessel with Doppler Ultrasonography before these surgeries,and designed the nasolabial fold wrapped perforator flap according to the area and size of nasal alar defects.The flap with reasonable thickness was able to repair the both sides of defect after being trimmed properly.Meanwhile,the flap could be folded to form a local flap covered or lined with skin.We rotated and transferred the flap to repair nasal alar defect.Result：All the flaps survived and all donor sites healed primarily.After 3 to 36 months of follow-up,the color,texture and thickness of the flaps was similar to those of recipient sites.The scar in donor site was minor.There was little scab skin in the nasal cavity.The cosmetic results was satisfactory.Conclusion：The nasolabial fold wrapped perforator flap has the advantages of reliable blood supply,long pedicle flap,proper thickness,outside the skin and the inner lining.The cosmetic appearance of nose is satisfactory.There was little scab skin in the nasal cavity.Also the sensory function of the external nose was retained.The nasolabial fold wrapped perforator flap technique provides an ideal reconstructive option for the nasal alar full-thickness defect repair at one-stage after tumor resection.

关 键 词：外鼻 肿瘤 鼻唇 皮瓣 缺损修复 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]