摘要
目的探讨鼻唇沟穿支皮瓣修复鼻软组织缺损的临床效果。方法术前用多普勒血流探测仪自内眦下方1.5 cm至口角之间探测面动脉走行及穿支动脉位置,以面动脉穿支形成鼻唇沟穿支皮瓣,修复鼻部软组织缺损。皮瓣长宽比最高可达9:1,皮瓣皮下脂肪厚度为2.0~3.0 mm;修复鼻软组织缺损面积1.2 cm×1.6 cm^2.7 cm×3.1 cm,共修复8例患者。结果所有患者术后皮瓣全部成活,其中2例术后发生静脉危象,予拆除部分缝线后缓解。随访5~24个月,皮瓣色泽、质地、外形良好,皮瓣不臃肿,鼻形态逼真。结论鼻唇沟穿支皮瓣因其具有血供可靠、无需吻合血管、皮瓣切取面积较大、皮下蒂窄而长、皮瓣厚薄适宜等优点,可较好地克服鼻唇沟随意皮瓣和鼻唇沟面动脉轴型皮瓣的缺点,使鼻唇沟皮瓣修复鼻部软组织缺损的效果更趋完美,值得临床推广。
Objective To explore the clinical efficacy of the nasolabial perforator flap in the repair of nasal soft tissue defects.Methods A Doppler blood stream detector was used to trace the facial artery and discover the locations of the perforator arteries from 1.5 cm below the inner canthus to the otis angulus before surgery.Nasolabial perforator flaps formed based on the perforate branch of facial artery were used to reconstruct defects of the nasal soft tissue.The ratio of the length and width of the flap ranged up to 9：1.The thickness of the subcutaneous fat was approximately 2.0 to 3.0 mm.The reconstructed area of the nasal soft tissue was from 1.2 cm × 1.6 cm to 2.7 cm × 3.1 cm.A total of 8 cases were included in this study.Results All flaps survived.Venous crisis occurred in 2 cases,which was relieved by partial removal of sutures.All cases were followed up from 5 to 24 months.The color,texture,and appearance of the flap was satisfacto ry.The flaps were not bloated.The nose shape was natural.Conclusion The nasolabial perforator flap has a reliable blood supply without vascular anastomosis.It can support a large area flap incision.The subcutaneous pedicle was narrow and long,and the flap thickness was appropriate.The nasolabial perforator flap allowed surgeons to overcome the shortcomings of the nasolabial random flap and the nasolabial facial artery flap.As the nasolabial flap can enable better reconstructive efficacy in the nasal soft tissue,it should be considered for promotion in clinic.
出处
《中国美容整形外科杂志》
CAS
2017年第6期349-351,共3页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
鼻唇沟
外科皮瓣
显微外科
软组织缺损
Nasolabial fold
Surgical flap
Microsurgery
Soft tissue defect
