Clinical Analysis Of 15 Cases Of Nasal Defect Repaired By Forehead Expanded Flap

Objective: To explore the application techniques and methods of nasal reconstruction with expanded frontal flaps in the repair and reconstruction of nasal defects,to evaluate its effects and to summarize experience.Methods: Analysis retrospectively of plastic surgery at the First Affiliated Hospital of Xinjiang Medical University from January 2002 to January 2020,15 cases of nasal defects were repaired by forehead expansion flap method,including 9 males and 6 females;There were 10 cases of trauma due to defects,and 5cases of secondary defects after tumor resection.Defect area: 2 cases of <1.5 × 1.5cm2,5cases of 1.5 × 1.5cm2 ~ 2.0 × 2.0cm2,3 cases of 2.0 × 2.0cm2 ~ 2.5 × 2.5cm2,and 5 cases of> ~ 2.5 × 2.5cm2.Defect parts: There were 8 cases of alar,9 cases of nasal tip,2 cases of nasal dorsum,3 cases of nasal wall,2 cases of nasal column,and 9 cases of trans subunit defects.There were 5 cases of total nasal defects and 3 cases of semi-nasal defects.In the same period,8 cases were repaired with lining and 8 cases were repaired with autologous costal cartilage.The defect surgery is divided into three phases: Phase I forehead skin and soft tissue dilator implantation;Phase II uses the forehead pedicled expanded forehead flap to transfer nasal defects,and lining and cartilage stents are used according to the nasal defect Repair;Stage III line frontal skin flap pedicle repair.Observe the postoperative aesthetic effect,functional recovery and complications.Results: All flaps survived,and the flaps had good blood flow after metastasis and pedicle rupture.The flap had no obvious retraction,the color and texture were similar to the adjacent tissues,the shape of the reconstructed nose was satisfactory,and the physiological function of the nasal cavity was not significantly affected.The forehead donor area healed well without obvious deformities.CONCLUSIONS: The frontal expansion flap method for nasal reconstruction has many stages,long treatment period,and high surgical requirements,and there are many factors affecting the postoperative effect.However,under the condition ofgood frontal skin,good aesthetic effect and functional recovery can be achieved,and the patient’s satisfaction is high,which can be used as a choice for the reconstruction of nasal defects or large nasal defects.