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目的探讨应用侧鼻动脉为蒂的鼻唇沟皮瓣修复鼻缺损的手术方法及疗效。方法2005年8月-2009年3月,收治鼻缺损患者12例。男5例,女7例;年龄35～60岁,平均48.6岁。其中外伤所致陈旧性鼻缺损5例,病程1～10年;肿瘤切除术后鼻缺损7例,病程3个月～40年。缺损范围为2.0cm×1.5cm～4.5cm×2.5cm。术中采用侧鼻动脉为蒂的鼻唇沟皮瓣修复缺损,其中9例为带蒂皮瓣,3例为轴型岛状皮瓣;皮瓣切取范围为2.5cm×2.0cm～7.0cm×3.0cm。其中5例取自体耳甲腔软骨移植重建鼻翼及鼻尖。供区直接拉拢缝合。结果术后5～24h,3例轴型岛状皮瓣远端出现静脉淤血现象,自行缓解;皮瓣全部成活。供、受区切口均Ⅰ期愈合。5例因皮瓣蒂部略显臃肿,于术后6～15个月行皮瓣修整术。12例患者均获随访,随访时间8～24个月,平均13个月。皮瓣质地柔软、色泽正常,鼻外形良好,无通气障碍。供区无明显瘢痕。结论侧鼻动脉为蒂的鼻唇沟皮瓣距鼻缺损部位近,具有血供丰富、成活率高、皮瓣质地好、供区可直接闭合等优点,是一种修复鼻尖及鼻翼缺损的较好方法。
Objective To investigate the surgical method and effect of nasolabial flap pedicled with lateral nasal artery for repairing nasal defect. Methods From August 2005 to March 2009, 12 patients with nasal defect were treated. 5 males and 7 females; aged 35 to 60 years, mean 48.6 years old. Among them, 5 cases of old nose defects caused by trauma, the course of 1 to 10 years; 7 cases of nasal defects after tumor resection, duration of 3 months to 40 years. The defect range is 2.0cm × 1.5cm ~ 4.5cm × 2.5cm. The lateral nasal artery pedicle nasolabial flap was used to repair the defect. Nine of them were pedicled flaps and three were axial island flaps. The skin flap was cut from 2.5cm × 2.0cm to 7.0cm × 3.0cm. Among them, 5 cases were obtained from the reconstruction of the nasal and nasal tip of the cartilage in the conchae. For the area directly draw suture. Results 5 ~ 24h after operation, 3 cases of axial island flap distal venous congestion, relieve itself; flaps all survived. For, by the District incision healed. 5 cases due to pedicle pedicle slightly bloated, 6 to 15 months after the line flap repair. All 12 patients were followed up for 8-24 months with an average of 13 months. Flap skin texture, normal color, good nose shape, no ventilation barrier. No scar for donor area. Conclusions The nasolabial fold pedicle pedunculated on the lateral nasal artery is near the nasal defect and has the advantages of abundant blood supply, high survival rate, good flap quality and direct supply of the donor area. It is a better method to repair nasal tip and nasal defect good idea.