摘要
目的探讨临床应用显微外科技术修复鼻部分缺损的方法.方法应用耳前和耳廓复合组织瓣供血的颞浅血管以旋股外侧血管搭桥与面动静脉吻合手术技术重建鼻部分组织缺损,供区采用耳后皮瓣转移一期修复.结果本组手术共修复28例不同部位的鼻部分缺损畸形病例.移植的耳廓复合组织瓣最大面积4.0 cm×2.5 cm,最小2.5 cm×1.5 cm,移植的血管桥长度最长14cm,最短10 cm.27例手术获得完全成功,医患双方对再造的鼻形态和色泽均表示满意,其中7例得到术后3～6个月随访,并有3例进行了门诊二期组织瓣蒂部臃肿修整术.随访病例对结果满意.失败1例的原因可能与年龄和长期吸烟、高血压、血管硬化,导致复合组织瓣血液灌注不足有关.结论应用显微外科技术移植耳前和耳廓复合瓣再造鼻部分缺损效果可靠,外形结果满意,供区部位形象可以接受.
Objective The nose is composed of several delicate subunits, some of which are difficult to reconstruct if they have been injured. The paper presents the microsurgical technique to repair the nasal subunit defects with the free combined preauricular and auricular flap which well match the nasal tissues in texture, contour and color. Methods The nasal subunit defects were repaired with the combined perauricular and auricular flap which were vascularized by the superficial temporal vascular system. The flap was harvested from the contralateral preauricular and the region of helix crus. The superficial temporal vessels were anastomosed to facial vessels via the vascular grafts harvested front the lateral circumfluent femoral vessels, which were about 10 to 14 cm in length. The helix crus of donor ear was reconstructed with the post-auricular flap. Results 28 cases were treated, including 3 cases of nasal tip defects, 9 cases of combined nasal alar and sidewall defects, and 16 cases of nasal alar defects. In these cases, the size of the subunit defects varied from 2.5 cm × 1.5 cm to 4 cm× 2.5 cm. 27 cases were successfully repaired with satisfactory results. The contour of reconstructed helix crus in donor site was acceptable. No walking dysfunction of the donor thigh was complained. There is one failed case, and the possible reason is the insufficient blood peffusion to the flaps, which may due to the patient＇s longtime-smoking status and the hypertention. Conclusions The technique of free combined preauricular and auricular flap is ideal for the reconstruction of nasal subunit defects.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2005年第6期457-460,共4页
Chinese Journal of Plastic Surgery
关键词
鼻
缺损
显微外科
皮瓣
Nose
Defect
Microsurgery
Flap
