鼻缺损鼻再造修复术中鼻缺损衬里的修复效果  

Effect of lining restoration in reconstruction of nasal defects

作　　者：段惠川[1] 周晓萍 李东[1] 周思政 徐梁[1] 俞哲元[1] 韦敏[1] 袁捷[1] Duan Huichuan;Zhou Xiaoping;Li Dong;Zhou Sizheng;Xu Liang;Yu Zheyuan;Wei Min;Yuan Jie(Department of Plastic and Reconstructive Surgery,Shanghai 9th People's Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200023,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海200023

出　　处：《中华医学美学美容杂志》2024年第4期316-319,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：上海交通大学医学院附属第九人民医院生物样本库项目(YBKB202221)

摘　　要：目的研究鼻缺损鼻再造修复过程中鼻缺损衬里修复的临床效果。方法回顾性纳入2010年1月至2022年12月上海第九人民医院整复外科收治鼻部缺损患者15例, 男8例、女7例, 年龄18~62岁, 平均38岁。缺损范围均超过鼻部1个亚单位, 均选择额部带蒂皮瓣修复。鼻再造选择扩张器植入扩张前额正中皮瓣;支架选择视缺损范围选择肋骨-肋软骨复合体移植、单纯肋软骨移植和耳软骨移植, 衬里的修复选择原位瘢痕皮肤翻转、局部鼻唇沟皮瓣翻转或大面积选择额部带蒂皮瓣修复鼻腔面的黏膜缺损。术后随访, 观察效果。结果 15例患者用肋骨-肋软骨复合体移植8例、肋软骨移植3例、耳软骨移植4例;皮瓣全部成活。1例出现局部感染, 予反复冲洗换药后患者恢复良好。术后随访6~24个月, 15例患者鼻缺损外形均得到明显改善, 效果满意。结论鼻缺损衬里的修复需根据具体缺损的部位、范围及供区的选择等综合分析, 最终确定手术方式, 效果较好。Objective To investigate the clinical outcomes of lining repair during the reconstruction of nasal defects.Methods From January 2010 to December 2022,our team treated 15 nasal defect patients aged between 18 and 62 years with an average age of 38,including 8 males and 7 females.The range of the defect was more than one subunit in all cases.And forehead pedicled flaps were chosen for repair.For nasal reconstruction,expander was implanted to expand the central forehead flap.The choice of support depended on the range of the defect,including rib-rib cartilage composite grafts,rib cartilage grafts and ear cartilage grafts.The repair of the lining was selected with the original skin,local nasolabial flapor forehead pedicled flap to repair the mucosal defect of the nose.Postoperative follow-up was conducted to observe the effects.Results Among the 15 patients,8 cases underwent rib-rib cartilage composite grafts.3 cases had rib cartilage grafts,and 4 cases had ear cartilage grafts.All the flaps survived with 1 case experiencing infection.Postoperative follow-up for 0.5 to 2 years showed that the appearance of nasal defects in all 15 cases was significantly improved,with satisfactory results.Conclusions The repair of nasal defect lining requires a comprehensive analysis based on the specific location,range of the defect,and the selection of the donor area in order to ultimately determine the surgical approach.

关 键 词：鼻 缺损 全鼻再造 衬里 修复 皮瓣 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]