额部皮瓣在鼻缺损修复中的应用  

Application of the Forehead Flap in Repairing Nasal Defect

作　　者：王珏 陈廉杰 苏若楠 李孔盈 王千文 周栩 WANG Jue;CHEN Lianjie;SU Ruonan;LI Kongying;WANG Qianwen;ZHOU Xu(Head and Neck Cosmetic Surgery Center,Beijing Plastic Surgery Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100144,China.)

机构地区：[1]中国医学科学院整形外科医院面颈整形中心,北京市100144

出　　处：《组织工程与重建外科杂志》2020年第5期369-373,共5页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：协和小规模特色办学经费资助青年教师培养项目。

摘　　要：目的探讨应用额部皮瓣修复鼻缺损并重建鼻亚单位的可行性。方法 2010年3月至2019年10月,应用额部皮瓣修复11例鼻全层缺损患者。一期以滑车上动脉为血管蒂切取额部皮瓣,远端去除皮下脂肪和额肌,保留真皮下血管网,中厚皮片移植作为衬里。3~4周后断蒂,将蒂部展平、修剪后还纳额部。3个月后行皮瓣修薄,由皮瓣近端掀起,根据需要行耳甲腔软骨移植,重塑鼻亚单位形态。结果 11例患者皮瓣完全成活,1例皮瓣转移后出现静脉回流障碍,经改善循环及针刺处理后缓解;全部患者术后随访2年,鼻部外形及功能满意。结论额部皮瓣组织量丰富,色泽、质地与鼻部相近,可有效修复鼻部缺损并获得满意效果。Objective To explore the feasibility of using the forehead flap in repairing nasal defect and reconstructing nasal subunits.Methods From March 2010 to October 2019,11 patients with full-thickness nasal defects were repaired with frontal flap.In the first stage,the superior trochlear artery was used as the vascular pedicle.The subcutaneous fat and frontal muscle were removed at the distal end,and the subdermal vascular network was preserved.After 3-4 weeks,the pedicel was cut off,flattened,trimmed and returned to the forehead.Three months later,the skin flap was thinned and lifted up from the proximal end of the flap.According to the needs,cartilage transplantation of concha cavity was performed to reconstruct the shape of nasal subunits.Results The flaps survived completely in 11 patients,and venous reflux obstruction occurred in 1 case after flap transfer,which was relieved after circulation improvement and acupuncture treatment.The nasal appearance and function were satisfactory after 2 years of follow-up.Conclusion The forehead flap is rich in tissue,similar in color and texture to the nose,which can effectively repair the nasal defect and obtain satisfactory result.

关 键 词：鼻缺损 额部皮瓣 鼻亚单位 

分 类 号：R622[医药卫生—整形外科]