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局部或邻位皮瓣修复鼻部软组织缺损的分区应用 |
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濮哲铭 施耀明 冯胜之 孙宝珊 许礼根
摘要：目的 探讨鼻部软组织缺损的有效方法，以尽可能使 修复组织在色泽、质地上与鼻部局部组织相近，且切口瘢痕隐蔽。方法 结合Burget鼻部美学分区，将其再分为三个区域，根据分区选用局部或邻位皮瓣修复 鼻部各区软组织缺损30例(鼻根部以Rintala鼻额部局部皮瓣推进3例；鼻中段的鼻背部行双 侧斧状局部皮瓣旋转3例；鼻侧壁行对侧壁局部皮瓣转移，供区植皮4例；鼻端部以鼻唇沟皮 下蒂岛状瓣转移修复鼻尖部7例；鼻唇沟局部皮瓣旋转修复鼻翼部7例；鼻背轴型皮瓣旋转修 复鼻小柱6例)。结果 修复效果满意。结论 根据鼻部分区选用局部或邻位皮瓣是修复鼻部软组织缺损的较好方法。
关键词：鼻； 组织缺损； 皮瓣
中图分类号：R765.9 文献标识码：A
文章编号：1004-6526(2000)05-0241-02
Nasal soft tissue defect: subunit reconstruction by local flaps
PU Zhe-ming SHI Yao-ming FENG Sheng-zhi, et al
（Plastic and Recon structive Surgery Department, Shanghai Ninth Pople′s Hospital 200011, China）
Abstract:Objective To find effective skin flaps for reco nstrution of nasal soft tissue defects, which match the local tissue both in col our and texture. Methods 30 cases of nasal soft tissue de fects were reconstructed by different kinds of local flaps according to modified Burget′s nasal subunit. The Rintala flaps were used above the lowest level of low eyelids; at the area between low eyelids and the alar groove, the dorsal def ects were covered by ax-like local flaps and defects on side wall were reconstru cted by flaps rotated from the contralateral wall covered by skin graft; when it was below the highest level of alar groove, nasolabial flaps with subdermal ped ical were applied to nasal tip defection, and nasolabial local flaps to alar def ects, axial nasodorsum flaps supplied by the lateral nasal artery to defects inv olving columellae. Results All patients have got satisfac tory result. Conclusion Subunit reconstruction by localfl aps is a good method for reconstruction of nasal soft tissue defects.
Key words:Nose; Tissue defect; Flap
鼻部位于面部中央显要位置，轻度畸形就会对人的外观有较大影响。为改善鼻部软组织缺损 的修复效果，根据鼻部分区的原则，行局部或邻位皮瓣修复鼻部各区软组织缺损30例，报道 如下。
1 临床资料
鼻部皮肤及软组织缺损30例，男性18例，女性12例，年龄7～58岁。病因依次为基底细胞癌1 2例，黑毛痣6例，血管瘤4例，先天发育畸形4例，外伤性皮肤缺损3例，瘢痕挛缩畸形1例。
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