Forehead Flap for Nasal Reconstruction

額頭皮瓣手術重建鼻部缺損

林寶源(Pao-Yuan Lin) ； 劉奕添(Yi-Tien Liu) ； 鄭勝峰(Seng-Feng Jeng) ； 葉明中(Ming-Chung Yeh) ； 陳添興(Tien-Hsing Chen) ； 賴瑞斌(Jui-Pin Lai) ； 江原正(Yuan-Cheng Chiang) ； 黃慧芬(Faye Huang)

《中華民國整形外科醫學會雜誌》 10卷2期 (2001/06) Pp. 112-118

https://doi.org/10.7096/JPSA.200106.0007

摘要

鼻部皮膚的顏色，厚度與結構和額頭皮膚最為接近，我們收集十五位鼻部缺損的病人以額頭皮瓣手術來進行重建，長期追蹤其捐贈區的結果。作者以十年的時問治療十五位病患（十三位男性、二位女性），年齡分布從三歲到七十歲，鼻部缺損的大小從 5.5×4平方公分到2.0×2.0平方公分,發生的原因有六例是因腫瘤切除，七例因外傷造成，二例因血管瘤治療而造成的畸形。缺損的部位，有五例為鼻尖，九例為鼻翼，一例為鼻側。額頭皮瓣是以上滑車動脈為基礎。九位病患需要軟骨來建立鼻部結構。額頭部位的傷口，直接修復的有六位病患（其傷口小於2.5cm，捐贈區直接修復的原則），利用自然癒合有九位病患，其皆使用親水性人工敷料。所有的重建都很成功而且沒有嚴重的併發症。分割手術安排在第一階段手術的三週後。所有傷口在四至五週內癒合。有一位病患在皮膚腫瘤切除後的一年內發生局部復發，有四位病人的皮瓣輕微充血。所有病人對接受區及捐贈區的手術後結果感到滿意。額頭皮瓣手術除建鼻部缺損可得到顏色及結構最佳的吻合，而且在東方人身上捐贈區的傷口大都可得到美觀上的結果。

並列摘要

Color, thickness, and texture of nasal skin are most accurately matched in forehead skin. Yet, the morbidity of visible donor site in oriental people would disturb the reconstructive surgeon. We collect 15 patients of nasal defects to be reconstructed with forehead flaps and observe the long-term results of donor site. The 15 patients (13 males and 2 females) had accepted a ten-year period of treatment, and the ages ranged from 3 to 70. The size of nasal defects ranged from 5.5X4 cm^2 to 2.0×2.0 cm^2. The etiology of defects came from 6 patients of skin cancer excision, 7 of traumatism, and 2 of secondary deformity after surgical treatments. The forehead flap based on supratrocblear artery was used to reconstruct the defects. The donor site defects could be through primary closure as the width of wound was less than 2.5 cm; if not, secondary healing with occlusive dressing for larger defect. All the reconstructions were successful without any major complications. The forehead donor sites were primarily repaired in 6 patients and healed by secondary intention in 9 patients whose wounds were healed within 4 to 5 weeks. All the patients were satisfied with the outcome functionally and cosmetically. Forehead flaps for nasal defects will get the most accurate color match and texture; and the donor site wound is acceptable for oriental patients, compared with the Caucasian.

並列關鍵字

nasal reconstruction ； forehead flap