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首页> 外文期刊>JAMA otolaryngology-- head & neck surgery >Repair of intermediate-size nasal defects: A working algorithm
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Repair of intermediate-size nasal defects: A working algorithm

机译：修复中等大小的鼻部缺陷：一种有效的算法

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CONCLUSIONS AND RELEVANCE There is a paucity of literature on the subject of reconstruction of intermediate-size nasal defects. This algorithm is derived from our practice and offers the surgeon specific reconstructive options for consideration when facing nasal defects of 1.5 to 2.5 cm. The algorithm is based on subunits.IMPORTANCE "Large" nasal defects are typically classified as larger than 1.5 cm. Within that group, however, there is a subset of patients with smaller nasal defects (1.5-2.5 cm) who are treated differently. This study examines the different methods that we have used in the reconstruction of such "intermediate-size" nasal defects.OBJECTIVE To review the treatment and outcomes of patients who have undergone reconstruction of intermediate-size nasal defects and to share our empirical algorithm.DESIGN, SETTING, AND PARTICIPANTS Thiswas a retrospective review at an academic university practice of all patients who had undergone reconstruction of intermediate-size (1.5-2.5 cm) nasal defects from January 1, 1999, to September 1, 2013. From these data, a working algorithm was derived.INTERVENTIONS Nasal reconstruction of intermediate-size nasal defects.MAIN OUTCOMES AND MEASURES Method of reconstructionwas correlated with site and size of defects. Postoperative complications were reviewed.RESULTS A total of 315 patients with nasal defects measuring 1.5 to 2.5 cm were identified. Of these, 199 patients (63.2%) had a defect in a single subunit, and 116 (37.8%) had involvement of a combination of subunits. Ninety-seven patients (30.8%) had local flaps, 94 patients (29.8%) had forehead flaps, 51 patients (16.2%) had full-thickness skin grafts (FTSG), 40 (12.7%) had composite grafts, and 33 (10.5%) had melolabial flaps. The defects were categorized according to subunit locations. There was a pattern of reconstruction for each defect according to their site, size, and depth. Alar defects were mainly repaired with melolabial flaps (25 of 85 patients [29.4%]), or by composite grafts (24 of 85 patients [28.2%]). Nasal tip defects were mainly repaired using local flaps (28 of 69 patients [40.5%]), FTSG (19 of 69 patients [27.5%]), and forehead flaps (19 of 69 patients [27.5%]). The reconstruction of choice in dorsal and sidewall defects were local flaps and forehead flaps. There were 28 wound-related complications, such as pincushioning, dehiscence, and infection (incidence rate, 8.9%), and 4 cases of postoperative nasal obstruction (1.3%).
机译：结论与相关性关于中型鼻缺损重建的文献很少。该算法是从我们的实践中得出的，当面对1.5至2.5 cm的鼻骨缺损时，可为外科医生提供特定的重建选择。该算法基于子单元。重要信息“大”鼻部缺陷通常被分类为大于1.5厘米。但是，在该组中，有一部分患者的鼻腔较小（1.5-2.5厘米），其治疗方法有所不同。这项研究探讨了我们用于重建这类“中等大小”鼻孔缺陷的不同方法。目的回顾经历中等大小的鼻孔缺陷重建患者的治疗和结果，并分享我们的经验算法。 ，地点和参与者这是一所大学大学实践的回顾性研究，回顾了从1999年1月1日到2013年9月1日经历了中等大小（1.5-2.5 cm）鼻腔缺损重建的所有患者。根据这些数据，干预措施对中等大小的鼻部缺陷进行鼻腔重建。主要结果和措施重建方法与病变部位和大小有关。结果总共315例鼻部大小在1.5到2.5 cm的患者被确认。在这些患者中，有199个患者（63.2％）患有单个亚基的缺陷，而116个患者（37.8％）参与了多个亚基的组合。 97例（30.8％）发生了局部皮瓣，94例（29.8％）发生了前额皮瓣，51例（16.2％）进行了全层皮移植（FTSG），40例（12.7％）进行了复合皮瓣，33例10.5％）有盂唇皮瓣。缺陷根据亚单元位置进行分类。根据缺陷的部位，大小和深度，有一种重建模式。翼骨缺损主要通过盂唇皮瓣修复（85例中的25例[29.4％]）或复合移植物修复（85例中的24例[28.2％]）。鼻尖缺损主要通过局部皮瓣（69例中的28例，占40.5％），FTSG（69例中的19例，占27.5％）和前额皮瓣（69例中的19例，占27.5％）进行修复。重建背侧和侧壁缺损的选择是局部皮瓣和前额皮瓣。有28个与伤口相关的并发症，例如枕形，开裂和感染（发生率8.9％），还有4例术后鼻塞（1.3％）。

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