Objective: To discuss a reliable and aesthetic surgery method for the reconstruction of large defects on the top of nose after giant nevi resection.
Methods: Between January 2011 and June 2015, 46 cases of nasal tip defects caused by giant nevi resection were treated. Of 46 cases, 22 were male and 24 were female, aged 15-59 years (median, 28 years). The right ala nasi was involved in 28 cases, the apex nasi in 8 cases, and the left ala nasi in 10 cases. The diameters of nevi were from 8 to 12 mm (mean, 9.75 mm); no alar cartilage was invaded. Hair growth was seen in 14 cases. The duration of nasal nevi was from 3 years to 49 years (mean, 9.8 years). There were 9 recurrent patients who received laser therapy before surgery. The defects sizes after excision were from 10 mm×10 mm to 14 mm×14 mm. The bilobed flaps were used for one-stage reconstruction, which sizes were from 11 mm×10 mm to 15 mm×14 mm and from 10 mm×10 mm to 15 mm×14 mm.
Results: All the incisions healed by first intention, and the flaps survived. No complication of intracranial hemorrhage or subdural hemorrhage occurred. The patients were followed up 6 months to 5 years (mean, 18 months). The appearance of nasal tip and nasolabial fold was satisfactory, and no recurrence was found during follow-up.
Conclusions: One-stage bilobed flap reconstruction for nasal tip defects after giant nevus resection is one of the effective, safe, and aesthetic surgery methods.
目的: 总结双叶皮瓣修复鼻尖部巨痣切除后皮肤缺损的疗效。.
方法: 2011年1月-2015年6 月，收治46例鼻尖部巨痣患者。男22例，女24例；年龄15～59岁，中位年龄28岁。黑色素痣偏右侧鼻翼28例，鼻尖正中8例，偏左侧鼻翼10例。黑色素痣直径8～12 mm，平均9.75 mm；向内均未侵犯鼻翼软骨；14例有毛发生长。病程3～49年，平均9.8年。既往行激光治疗后复发9例。黑色素痣切除后遗留缺损范围为10 mm×10 mm～14 mm×14 mm，一期采用双叶皮瓣修复，皮瓣切取范围分别为11 mm×10 mm～15 mm×14 mm、10 mm×10 mm～15 mm×14 mm。.
结果: 术后皮瓣均顺利成活，切口Ⅰ期愈合；均未发生颅内及硬膜下出血等围手术期并发症。患者均获随访，随访时间6个月～5年，平均18个月。鼻尖及鼻唇沟外观良好，随访期间局部黑色素痣无复发。.
结论: 双叶皮瓣一期修复鼻尖部巨痣切除术后皮肤缺损安全，鼻部外观恢复较好。.
Keywords: Bilobed flaps; Gaint nevi; Nasal tip; Wound repair.