Nasal Reconstruction

鼻子 医学 前额 软骨 外科 计算机科学 解剖
作者
Frederick J. Menick
出处
期刊:Plastic and Reconstructive Surgery [Lippincott Williams & Wilkins]
卷期号:125 (4): 138e-150e 被引量:155
标识
DOI:10.1097/prs.0b013e3181d0ae2b
摘要

In Brief Learning Objectives: After studying this article, the participant should be able to: 1. Understand nasal wound healing and develop an organized approach to defect analysis. 2. Understand a regional unit approach to nasal repair. 3. Understand the appropriate use and advantages and disadvantages of the two- and three-stage vertical paramedian forehead flap. 4. Appreciate the uses and design of nasal support grafts. 5. Differentiate old and new lining methods and their advantages and disadvantages and develop an approach to the revision of a nasal reconstruction. Summary: The face tells the world who we are and materially influences what we can become. The nose is a primary feature. Thin, supple cover and lining are shaped by a middle layer of bone and cartilage support to create its characteristic skin quality, border outline, and three-dimensional contour. The delicacy of its tissues, its central projecting location, and the need to reestablish both a normal appearance and functional breathing make its reconstruction difficult. Nasal repair requires careful analysis of the anatomical and aesthetic deficiencies. Because the wound does not accurately reflect the tissue deficiency, the repair is determined by the "normal." A preliminary operation may be required to ensure clear margins, recreate the defect, reestablish a stable nasal platform on which to build the nose, and prepare tissues for transfer. Major nasal defects require resurfacing with forehead tissue; support with septal, ear, or rib grafts; and replacement of missing lining. This requires a staged approach. RELATED VIDEO AVAILABLE ONLINE.
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