One-Stage Midline Forehead Flap for Nasal Reconstruction Following Removal of Foreign Body

以改良式的正中前額根蒂皮瓣對接受手術清除異物後的鼻部重建

張松源(Sung-Yuan Chang) ； 鄭明輝(Ming-Huei Cheng) ； 翁昭仁(Chau-Jin Wen) ； 賴永隆(Yung-Lung Lai)

《中華民國重建整形外科醫學會雜誌》 8卷2期 (1999/06) Pp. 88-96

https://doi.org/10.7096/JPRSA.199906.0004

摘要

藉由局部異物注射以達到顔面輪廓的增強，在過去數十年曾於坊間被大量施行；雖目前已被政府明令禁止，但因接受此種非專業手術而造成的局部組織病變或皮膚潰瘍並不少見，而鼻部亦是常見接受此種局部異物注射的受害者之一。
原則上，保守性治療使傷口能自行癒合或局部組織發炎可緩解爲優先攷慮，因爲臉部組織缺陷的重建是非常不容易的；正中前額根蒂皮瓣爲一早已被公認最適合做爲鼻部重建的方式，但是傳統做法必須讓病人再等二至三週，才接受第二階段手術，以完成根蒂切除並修飾皮瓣。
我們藉由根蒂去表皮化(deepitheliarization)將傳統方式修改，而使鼻部重建能一次完成；文中提出叁位病人之實際治療經驗，並加以討論之。

並列摘要

Conventional midline forehead flap is an excellent option for nasal defects reconstruction. However, the disadvantages of this procedure are the waiting period of at least 2 weeks with a raw surface and a subsequent surgery for division and revision of its pedicle. Through the usage of the de-epithelialized pedicle, the midline forehead flap was modified to be an one-stage technique to cover the soft tissue defect of the nose after removal of foreign body. We performed the mentioned procedure on three patients, and, at a mean follow-up of 50 months, all patients were satisfied with the aesthetic results. The one-stage midline forehead flap has the advantage of a reliable and constant blood supply without having to divide the pedicle. Furthermore, the procedure could be applied on noses with defect of small to moderate size for soft tissue augmentation. The pitfall of congestion of the flap should be observed and could be relieved conservatively after surgery. So far we are convinced of the valuable benefit after modification of conventional midline forehead flap for nasal reconstruction.

並列關鍵字

midline forehead flap ； foreign body injection ； nasal reconstruction