鼻唇沟皮瓣联合耳廓复合组织瓣修复基底细胞癌切除术后鼻翼全层缺损的临床探讨  

Nasolabial flap combined with auricle composite tissue flap in reconstructing of nasal alar full thickness defects after excision of basal cell carcinoma

作　　者：马绍崴 李函聪 周思淇 岑瑛[1] 卿勇[1] 伍俊良[1] MA Shaowei;LI Hancong;ZHOU Siqi;CEN Ying;QING Yong;WU Junliang(Department of Plastic and Burn Surgery,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院整形外科/烧伤科,成都610041 [2]四川大学华西临床医学院,成都610041

出　　处：《华西医学》2024年第12期1893-1898,共6页West China Medical Journal

基　　金：四川大学华西医院学科卓越发展1·3·5工程项目(ZYPY20009)。

摘　　要：目的探讨鼻唇沟皮瓣联合去耳廓背侧皮肤的耳廓复合组织瓣修复鼻翼基底细胞癌切除术后全层缺损的方法。方法选择2016年1月—2018年1月四川大学华西医院整形外科/烧伤科基底细胞癌术后单侧鼻翼全层缺损的病例资料。所有患者基底细胞癌切除术后均存在单侧鼻翼全层缺损,根据缺损大小一期采用鼻唇沟皮瓣联合去耳廓背侧皮肤的耳廓复合组织瓣进行鼻翼修复重建,术后1个月行二期皮瓣断蒂术。观察患者的皮瓣及耳廓复合组织瓣成活情况、肿瘤复发情况、患侧鼻翼外形、术区瘢痕情况、患者满意度。结果共纳入患者18例。其中,男5例,女13例。18例患者术后均获随访36个月,术后皮瓣及耳廓复合组织瓣均成活良好,且未见肿瘤复发。患者患侧鼻翼外形满意,术区瘢痕隐蔽,鼻面角得到了很好保护,所有患者对鼻部外形和面部轮廓满意。结论鼻唇沟皮瓣联合去除耳廓背侧皮肤的耳廓复合组织瓣修复基底细胞癌术后鼻翼全层缺损的两期手术修复方案,操作简单,术后鼻翼外观良好,同时可较好地保护鼻面角不被破坏,值得广泛推广。Objective To investigate the approach of using a nasolabial flap in conjunction with an auricular composite tissue flap with the skin on the dorsal aspect of the auricle excised for the restoration of full-thickness defects of the nasal ala following the removal of basal cell carcinoma.Methods The data of unilateral nasal alar full-thickness defect after basal cell carcinoma surgery at Department of Plastic and Burn Surgery of West China Hospital,Sichuan University between January 2016 and January 2018 were selected.All patients had full-thickness defects of the unilateral nasal ala after surgery.According to the size of the defect,the nasal labial sulcus flap combined with the auricular composite tissue flap with the skin on the back of the auricle removed was used for nasal ala repair and reconstruction in the first stage.The pedicle division of the flap was performed in the second stage one month after the surgery.The observation contents included:the survival situation of the flap and the auricular composite tissue flap,the recurrence situation of the tumor,the appearance of the affected nasal ala,the scar situation in the surgical area,and the patient satisfaction.Results A total of 18 patients were included.Among them,there were 5 males and 13 females.All 18 patients were followed up for 36 months postoperatively.The postoperative flaps and auricular composite tissue flaps survived favorably,and no tumor recurrence was detected.The contour of the affected nasal ala was satisfactory,the surgical scars were inconspicuous,and the nasofacial angle was effectively maintained.All patients expressed satisfaction with the appearance of the nose and the facial profile.Conclusions The two-stage surgical repair protocol involving the use of a nasolabial flap in combination with an auricular composite tissue flap with the skin on the back of the auricle removed for repairing the full-thickness defect of the nasal ala after basal cell carcinoma of the nasal ala is straightforward in execution.It can yield a favorable na

关 键 词：耳廓复合组织瓣 鼻唇沟皮瓣 鼻翼全层缺损 基底细胞癌 

分 类 号：R739.62[医药卫生—肿瘤]