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目的探讨鼻唇沟皮瓣联合耳甲腔软骨移植修复鼻翼基底细胞癌切除术后皮肤软组织缺损的疗效。方法 2012年1月-2014年8月,收治鼻翼基底细胞癌患者8例。男5例,女3例;年龄45~76岁,平均65岁。左侧鼻翼3例,右侧鼻翼5例。均存在鼻翼皮肤病损,反复破溃无好转。经病理检查确诊;确诊至该次手术时间为7~14 d,平均10 d。术中病变组织切除后缺损范围为1.5 cm×1.5 cm~2.0 cm×1.5 cm,采用大小为4.0 cm×1.5 cm~5.0 cm×2.0 cm的鼻唇沟皮瓣联合耳甲腔软骨移植修复。一期术后6个月行皮瓣断蒂并修薄术。结果术后皮瓣均顺利成活,创面Ⅰ期愈合。二期断蒂术中未见肿瘤复发,断蒂后切口Ⅰ期愈合。患者均获随访6个月。患侧鼻翼无塌陷,术区未见明显瘢痕。患者对鼻外形满意。结论鼻唇沟皮瓣联合耳甲腔软骨移植修复鼻翼基底细胞癌术后皮肤软组织缺损,具有操作简便、切口隐蔽且不遗留明显瘢痕、鼻翼外观较好的优点,但需行两期手术是其不足。
Objective To investigate the curative effect of nasolabial flap combined with otolaryngotial cartilage transplantation on skin and soft tissue defects after resection of nasal basal cell carcinoma. Methods From January 2012 to August 2014, 8 patients with nasal basal cell carcinoma were treated. 5 males and 3 females; aged 45 to 76 years old, average 65 years old. 3 cases of the left nose, 5 cases of the right nose. There are lesions of the nose skin, repeated ulceration no improvement. Confirmed by pathological examination; confirmed to the time of surgery was 7 ~ 14 d, an average of 10 d. The size of the defect was 1.5 cm × 1.5 cm ~ 2.0 cm × 1.5 cm. The size of the nasolabial fold flap was 4.0 cm × 1.5 cm ~ 5.0 cm × 2.0 cm. Six months after the operation, pedicle flap pedicel and thinning surgery. Results The flaps survived successfully and the wound healed in the first stage. No recurrence of tumor was found in the second stage of pedicel and the incision healed in the first stage after pedunculated pedicle. All patients were followed up for 6 months. No damage to the affected side of the nose, no significant scar surgery. Patient satisfied with nasal shape. Conclusions The nasolabial fold flap combined with otolaryngologic cartilage transplantation for the repair of postoperative skin and soft tissue defects of the nasal basal cell carcinoma has the advantages of simple operation, concealed incision without significant scarring and better appearance of the alar wing. However, insufficient.