Application of local skin flaps in adjustment of reconstructed nasal alars at second stage_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

JIANG Zhiyuan ^1,2 ,  YOU Xiaobo ^1,2 , CAI Zhen ² , LIU Quan ² , TANG Kuangyun ² , ZHANG Han ² , CUI Wei ² , CHEN Zaihong ² , LUO Shan ²

1. Graduate School of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;
2. Department of Plastic Surgery, Sichuan Provincial People’s Hospital & Sichuan Academy of Medical Sciences, Chengdu Sichuan, 610072, P.R.China;

Corresponding author：

YOU Xiaobo, Email: yxbprs@163.com

Keywords：

Nasal alar defect; local skin flap; V-Y plasty; Z plasty; reconstruction

DOI：

10.7507/1002-1892.201707113

Video：

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Objective To investigate the effectiveness of local skin flaps such as V-Y advancement flap (V-Y plasty) and transposition flap (Z plasty) in the adjustment of reconstructed nasal alars at second stage. Methods Between June 2012 and January 2017, 14 cases of reconstructed nasal alars by nasolabial flap or expanded forehead flap were recruited. There were 9 males and 5 females with an average age of 34.8 years (range, 18-52 years). The interval time between one- and two-stage operations was 1-12 months (mean, 3 months). The type of local skin flap was decided according to the flaws of reconstructed nasal alars. V-Y plasty was used in 5 cases, Z plasty in 2 cases, and V-Y plasty combined with Z plasty in 7 cases. Results All operations were successfully completed. The flaps in 3 cases suffered from epidermal necrosis at the far end and healed by dressing change. The other wounds healed by first intention. All 14 cases were followed up 6-40 months (mean, 12 months). The nasal alars had verisimilar shape and symmetrical appearance. The color and texture of reconstructed nasal alar were closed to peripheral tissues. Conclusion Applying local skin flaps such as V-Y plasty and Z plasty can acquire a better shape in the adjustment of reconstructed nasal alars.

Citation： JIANG Zhiyuan, YOU Xiaobo, CAI Zhen, LIU Quan, TANG Kuangyun, ZHANG Han, CUI Wei, CHEN Zaihong, LUO Shan. Application of local skin flaps in adjustment of reconstructed nasal alars at second stage. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(1): 55-58. doi: 10.7507/1002-1892.201707113 Copy

1.	Cox A, Fort M. Nasal reconstruction involving multiple subunit defects. Facial Plast Surg, 2017, 33(1): 58-66.
2.	Zelken JA, Reddy SK, Chang CS, et al. Nasolabial and forehead flap reconstruction of contiguous alar-upper lip defects. J Plast Reconstr Aesthet Surg, 2017, 70(3): 330-335.
3.	孙洋, 邵英, 李甜, 等. 带轴心血管的鼻唇沟皮瓣修复多个亚单位鼻缺损一例. 中国修复重建外科杂志, 2017, 31(2): 256.
4.	Fischer H. Nasal reconstruction with the paramedian forehead flap—details for success. Facial Plast Surg, 2014, 30(3): 318-331.
5.	Nordmann M, Veit J, Rotter N, et al. Autologous composite grafts from the cavum conchae for reconstruction of multilayer nasal defects. HNO, 2016, 64(5): 288-291.
6.	Aynehchi BB, Westreich RW. Lateral nasal artery pedicled island flap for repair of nasal alar defects. Otolaryngol Head Neck Surg, 2012, 146(3): 382-384.
7.	徐梁, 俞哲元, 袁捷, 等. 鼻面沟带蒂皮瓣在鼻部亚单位缺损修复中的应用. 组织工程与重建外科杂志, 2016, 12(3): 147-176.
8.	朱光辉, 卢彬, 张树青, 等. 额部扩张皮瓣在鼻缺损整复中的应用. 中国美容医学, 2016, 25(7): 28-31.
9.	马腾霄, 张正文, 谢峰, 等. 应用额部扩张皮瓣修复鼻缺损. 中国美容医学, 2014, 23(20): 1684-1687.
10.	Campbell T, Eisen DB. Free cartilage grafts for alar defects coupled with secondary-intention healing. Dermatol Surg, 2011, 37(4): 510-513．.
11.	刘全, 游晓波, 蔡震, 等. 耳廓复合组织瓣修复鼻翼缺损的临床疗效观察. 成都医学院学报, 2016, 11(5): 578-580.
12.	Durgun M, Özakpınar HR, Selçuk CT, et al. Repair of full-thickness nasal alar defects using nasolabial perforator flaps. Ann Plast Surg, 2015, 75(4): 414-417.
13.	Kallini JR, Mattox AR, Maher IA. Z-Plasty for Alar Groove Correction. Dermatol Surg, 2016, 42(6): 783-786.
14.	Bryan ZT, Garrett AB, Lavigne K, et al. The Wave Flap: A Single-Stage, Modified Nasal Sidewall Rotation Flap for the Repair of Defects Involving the Mid-Alar Groove. Dermatol Surg, 2016, 42(2): 176-182.
15.	Totonchi A, Guyuron B. Alar Rim Deformities. Clin Plast Surg, 2016, 43(1): 127-134.
16.	Seo YJ, Hwang C, Choi S, et al. Midface reconstruction with various flaps based on the angular artery. J Oral Maxillofac Surg, 2009, 67(6): 1226-1233.
17.	宋振涛, 张博, 陈冬梅, 等. 额部扩张皮瓣联合耳软骨支架鼻再造术. 中国美容医学, 2012, 21(4): 564-565.
18.	Funayama E, Yamamoto Y, Furukawa H, et al. Full-Thickness Entire Nasal Alar Reconstruction Using a Forehead Flap in Asians: No Cartilaginous Infrastructural Lining Is Necessary. J Craniofac Surg, 2017, 28(3): 734-737.

1. Cox A, Fort M. Nasal reconstruction involving multiple subunit defects. Facial Plast Surg, 2017, 33(1): 58-66.
2. Zelken JA, Reddy SK, Chang CS, et al. Nasolabial and forehead flap reconstruction of contiguous alar-upper lip defects. J Plast Reconstr Aesthet Surg, 2017, 70(3): 330-335.
3. 孙洋, 邵英, 李甜, 等. 带轴心血管的鼻唇沟皮瓣修复多个亚单位鼻缺损一例. 中国修复重建外科杂志, 2017, 31(2): 256.
4. Fischer H. Nasal reconstruction with the paramedian forehead flap—details for success. Facial Plast Surg, 2014, 30(3): 318-331.
5. Nordmann M, Veit J, Rotter N, et al. Autologous composite grafts from the cavum conchae for reconstruction of multilayer nasal defects. HNO, 2016, 64(5): 288-291.
6. Aynehchi BB, Westreich RW. Lateral nasal artery pedicled island flap for repair of nasal alar defects. Otolaryngol Head Neck Surg, 2012, 146(3): 382-384.
7. 徐梁, 俞哲元, 袁捷, 等. 鼻面沟带蒂皮瓣在鼻部亚单位缺损修复中的应用. 组织工程与重建外科杂志, 2016, 12(3): 147-176.
8. 朱光辉, 卢彬, 张树青, 等. 额部扩张皮瓣在鼻缺损整复中的应用. 中国美容医学, 2016, 25(7): 28-31.
9. 马腾霄, 张正文, 谢峰, 等. 应用额部扩张皮瓣修复鼻缺损. 中国美容医学, 2014, 23(20): 1684-1687.
10. Campbell T, Eisen DB. Free cartilage grafts for alar defects coupled with secondary-intention healing. Dermatol Surg, 2011, 37(4): 510-513．.
11. 刘全, 游晓波, 蔡震, 等. 耳廓复合组织瓣修复鼻翼缺损的临床疗效观察. 成都医学院学报, 2016, 11(5): 578-580.
12. Durgun M, Özakpınar HR, Selçuk CT, et al. Repair of full-thickness nasal alar defects using nasolabial perforator flaps. Ann Plast Surg, 2015, 75(4): 414-417.
13. Kallini JR, Mattox AR, Maher IA. Z-Plasty for Alar Groove Correction. Dermatol Surg, 2016, 42(6): 783-786.
14. Bryan ZT, Garrett AB, Lavigne K, et al. The Wave Flap: A Single-Stage, Modified Nasal Sidewall Rotation Flap for the Repair of Defects Involving the Mid-Alar Groove. Dermatol Surg, 2016, 42(2): 176-182.
15. Totonchi A, Guyuron B. Alar Rim Deformities. Clin Plast Surg, 2016, 43(1): 127-134.
16. Seo YJ, Hwang C, Choi S, et al. Midface reconstruction with various flaps based on the angular artery. J Oral Maxillofac Surg, 2009, 67(6): 1226-1233.
17. 宋振涛, 张博, 陈冬梅, 等. 额部扩张皮瓣联合耳软骨支架鼻再造术. 中国美容医学, 2012, 21(4): 564-565.
18. Funayama E, Yamamoto Y, Furukawa H, et al. Full-Thickness Entire Nasal Alar Reconstruction Using a Forehead Flap in Asians: No Cartilaginous Infrastructural Lining Is Necessary. J Craniofac Surg, 2017, 28(3): 734-737.

Chinese Journal of Reparative and Reconstructive Surgery

Application of local skin flaps in adjustment of reconstructed nasal alars at second stage

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