From Sept 1989 to Dec 1993, the auricular composite graft carrying a piece of postauriclar skin with subdermal vascular network was used to repair 7 cases having defects of nasal alar or tip and 1 having microtia. The width of the composite grafts ranged from 1.8cm to 2.6cm, and the size of the postauricular skin rangedfrom 0.08×1cm2 to 2.2×2.5cm2. All cases gained successful results. The mechanism of survival of the composite grafts, and the essential points in operation were detailed.
目的 总结改良耳廓复合组织瓣修复鼻翼巨大缺损的方法和经验。 方法 2005年9月－2010年9月共收治11例巨大鼻翼缺损患者，术前根据鼻翼缺损的形状、大小和位置设计切取耳廓复合组织瓣的形状、大小和部位，供瓣区分层缝合。游离组织瓣分层嵌入间断缝合于受区。术后随访1～3年。 结果 11例皮瓣均完全存活，颜色与周围皮肤无明显差异，表面无黑痂，无表皮分离，随访见周围缝合切口轻微瘢痕形成，复合组织瓣无明显挛缩，与健侧对比形态自然、大小差异不明显，供瓣区耳廓形态良好。 结论 通过细致合理的设计及复合组织瓣嵌入后缝合，配合术后促进局部血液循环治疗，改良耳廓复合组织瓣植入法可有效修复巨大鼻翼缺损。
Objective To investigate the effectiveness of nasolabial flap and ear cartilage in repairing defects after nasal ala basal cell carcinoma resection. Methods Between January 2012 and August 2014, 8 patients with nasal ala basal cell carcinoma underwent tumor resection and defect repair with nasolabial flap and ear cartilage. Among the 8 patients, 5 were male and 3 were female, with an average age of 65 years (range, 45-76 years). The left side and right side were involved in 3 cases and 5 cases respectively. Carcinoma confirmed by pathological examination in all patients. The time between first biopsy and resection was 7-14 days (mean, 10 days). The defect ranged from 1.5 cm×1.5 cm to 2.0 cm×1.5 cm after tumor resection, and the size of nasolabial flaps ranged from 4.0 cm×1.5 cm to 5.0 cm×2.0 cm. The operations of cutting off the pedicle and thinning skin flap were performed at 6 months after first operation. Results All flaps survived. Incisions healed by first intention, and no related complication occurred. No carcinoma recurred after cutting off the pedicle. All patients were followed up for 6 months. All patients were satisfied with the nasal contour, symmetrical projection of the alar dome, and no obvious scar. Conclusion Nasolabial flap transfer and ear cartilage transplant method not only can repair the nasal ala defects, but also can avoid obvious scar and obtain good nasal ala contour profile. The shortcoming is that patients have to receive two operations.
Objective To investigate the effectiveness of local skin flaps such as V-Y advancement flap (V-Y plasty) and transposition flap (Z plasty) in the adjustment of reconstructed nasal alars at second stage. Methods Between June 2012 and January 2017, 14 cases of reconstructed nasal alars by nasolabial flap or expanded forehead flap were recruited. There were 9 males and 5 females with an average age of 34.8 years (range, 18-52 years). The interval time between one- and two-stage operations was 1-12 months (mean, 3 months). The type of local skin flap was decided according to the flaws of reconstructed nasal alars. V-Y plasty was used in 5 cases, Z plasty in 2 cases, and V-Y plasty combined with Z plasty in 7 cases. Results All operations were successfully completed. The flaps in 3 cases suffered from epidermal necrosis at the far end and healed by dressing change. The other wounds healed by first intention. All 14 cases were followed up 6-40 months (mean, 12 months). The nasal alars had verisimilar shape and symmetrical appearance. The color and texture of reconstructed nasal alar were closed to peripheral tissues. Conclusion Applying local skin flaps such as V-Y plasty and Z plasty can acquire a better shape in the adjustment of reconstructed nasal alars.