코 결손 부위에 따른 다양한 재건 (Various Methods of Reconstruction in Nasal Defect)

서지정보

· 발행기관 : 대한두개안면성형외과학회
· 수록지 정보 : Archives of Craniofacial Surgery / 11권 / 1호 / 13 ~ 18페이지
· 저자명 : 김석권, 양진일, 권용석, 이근철

초록

Purpose: Nasal defect can be caused by excision of tumor, trauma, inflammation from foreign body reaction.
Nose is located in the middle of face and protruded,reconstruction should be done in harmony with size, shape,color, and textures. We report various methods of nasal reconstruction using local flaps.
Methods: From March 1998 to July 2008, 36 patients were operated to reconstruct the nasal defects. Causes of the nasal defects were tumor (18 cases), trauma (11 cases),inflammation from foreign body reaction (5 cases) and congenital malformation (2 cases). The sites of the defects were ala (22 cases), nasal tip (8 cases) and dorsum (6cases). The thickness of the defects was skin only (5cases), dermis and cartilagenous layer (7 cases) and fullthickness (24 cases). According to the sites and thickness of the defects, various local flaps were used. Most of alar defects were covered by nasolabial flaps or bilobed flaps and the majority of dorsal and tip defects were covered by paramedian forehead flaps. Small defects below 0.25 cm2were covered with composite graft or full-thickness skin graft.
Results: The follow-up period was 14 months. Partial flap necrosis was observed in a case, and one case of infection was reported, it was improved by wound revision and antibiotics.
Nasal reconstruction with various local flaps could provide satisfactory results in terms of color and texture match.
Conclusion: The important factors of nasal reconstruction are the shape of reconstructed nose, color, and texture.
Nasolabial flap is appropriate method for alar or columellar reconstruction and nasolabial island flap is suitable for tip defect. The defect located lateral wall could be reconstructed with bilobed flap for natural color and texture. Skin graft should be considered when the defect could not afford to be covered by adjacent local flap. And entire nasal defect or large defect could be reconstructed by paramedian forehead flap.
(J Korean Cleft Palate Craniofac Assoc 11: 13, 2010)

영어초록

Purpose: Nasal defect can be caused by excision of tumor, trauma, inflammation from foreign body reaction.
Nose is located in the middle of face and protruded,reconstruction should be done in harmony with size, shape,color, and textures. We report various methods of nasal reconstruction using local flaps.
Methods: From March 1998 to July 2008, 36 patients were operated to reconstruct the nasal defects. Causes of the nasal defects were tumor (18 cases), trauma (11 cases),inflammation from foreign body reaction (5 cases) and congenital malformation (2 cases). The sites of the defects were ala (22 cases), nasal tip (8 cases) and dorsum (6cases). The thickness of the defects was skin only (5cases), dermis and cartilagenous layer (7 cases) and fullthickness (24 cases). According to the sites and thickness of the defects, various local flaps were used. Most of alar defects were covered by nasolabial flaps or bilobed flaps and the majority of dorsal and tip defects were covered by paramedian forehead flaps. Small defects below 0.25 cm2were covered with composite graft or full-thickness skin graft.
Results: The follow-up period was 14 months. Partial flap necrosis was observed in a case, and one case of infection was reported, it was improved by wound revision and antibiotics.
Nasal reconstruction with various local flaps could provide satisfactory results in terms of color and texture match.
Conclusion: The important factors of nasal reconstruction are the shape of reconstructed nose, color, and texture.
Nasolabial flap is appropriate method for alar or columellar reconstruction and nasolabial island flap is suitable for tip defect. The defect located lateral wall could be reconstructed with bilobed flap for natural color and texture. Skin graft should be considered when the defect could not afford to be covered by adjacent local flap. And entire nasal defect or large defect could be reconstructed by paramedian forehead flap.
(J Korean Cleft Palate Craniofac Assoc 11: 13, 2010)

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