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患者女,5岁.左侧先天性鼻侧裂,表现为鼻一眼裂型.检查:左侧鼻翼全层裂开至内眦角水平,伴有左侧鼻翼缺损畸形,鼻翼缘形态尚完整,下睑内侧皮肤组织裂开,睑、球结膜暴露.全麻下手术.于左鼻背处作弧形切口,全层切开鼻翼组织,将鼻翼缘下移复位缝合,遗留鼻背处洞穿性缺损约1.3cm×3.0cm.以右侧眶上动脉及滑车上动脉为供应血管,设计3.0cm×3.0cm额部皮瓣,蒂宽2cm,长3cm,在骨膜上疏松组织层分离皮瓣,注意保护蒂部血管,然后切除皮瓣中央4mm宽纵形皮肤组织,形成横行并列双皮岛皮瓣.将两皮岛折叠180°缝合,一侧皮岛作村里修复鼻粘膜,另一侧修复皮肤缺损.将皮瓣通过鼻根部皮下隧道,转移修复鼻背部组织缺损.额部创面采用两侧滑行皮瓣推进后直接缝合.术中同时修复下睑处眼裂,术后皮瓣成活良好.两年后复查,鼻侧裂修复良好,鼻翼外形满意,左侧鼻腔通畅,前额部疤痕不明显.
The patient’s female, 5 years old, congenital nasal fissure on the left showed a nasolabial fissure.Check: The left atrial fontanelle ruptured to the level of internal horns, accompanied by left nasal defect, nasal flange morphology is still intact, Lower eyelid medial skin tissue rupture, eyelid, conjunctival exposure.Anesthesia surgery.An arc at the left nasal incision, full-thickness incision of the alar wing tissue, the nasal flange reduction and reduction of the suture, leaving the back of the nose piercing The defect was about 1.3cm × 3.0cm. The right supraorbital artery and the superior artery were used to supply the blood vessel. A 3.0cm × 3.0cm forehead flap was designed, the width of the pedicle was 2cm and the length was 3cm. The flaps were separated on the loose periosteum, Attention to protect the pedicle blood vessels, and then cut the center of the skin 4mm wide vertical skin tissue, forming a parallel row of double skin island flap.The two islands folded 180 ° suture, side of the island for the village repair nasal mucosa, the other side of the skin repair Defect.The flap through the nasal root subcutaneous tunnel, transfer and repair of nasal and dorsal tissue defects.On the frontal wound using two sides of the gliding flap advancement and direct suture.At the same time repair the lower eyelid at the eye crack, postoperative flap survival well .Two After years of review, nasal fissure repair is good, satisfied with the shape of the nose, left nasal patency, forehead scar Obviously.