Background In full-thickness nasal defects,the internal lining is perhaps the most challenging aspect of the three layers to rebuild.Nasal damage is usually more concentrated on the tip,soft triangles,alar wings,and c...Background In full-thickness nasal defects,the internal lining is perhaps the most challenging aspect of the three layers to rebuild.Nasal damage is usually more concentrated on the tip,soft triangles,alar wings,and columella,but the lateral nasal arteries are often left intact and the damage to the dorsal sidewalls are normally superficial.Methods Twelve patients who required total nasal reconstruction received a forehead flap placement as external coverage and autologous rib cartilage as structural support.Residual normal/superficial scar tissue flaps on the dorsal sidewalls with lateral nasal artery pedicles were mobilized and designed for internal lining repair without creating secondary donor site damage.The flaps were then turned 180°downward and placed between the alar medial angles and the fornix.Results No total lining flap necrosis occurred in all the patients.Partial necrosis occurred on the distal edge owing to overpressure of the nostril splint to the flaps;however,the wounds eventually healed,and the nasal structural integrity was preserved.The patients were satisfied with the aesthetic results and had no complaints of airway stenosis.Conclusions Lateral nasal artery pedicle dorsal sidewall skin flaps are appropriately thick,providing enough nostril circumferential support to improve airway stenosis.It allows sufficient blood supply and creates no extra donor site damage.Blood vessels and skin flaps are often undamaged,thereby allowing maximum application in total nasal reconstruction.展开更多
Background:Nasal defects due to rat bites are frequently encountered in rural regions of China.In addition to serving as disease vectors,rats can also inflict bite injuries.In this study,we delineated the characterist...Background:Nasal defects due to rat bites are frequently encountered in rural regions of China.In addition to serving as disease vectors,rats can also inflict bite injuries.In this study,we delineated the characteristics of rat bite injuries in the nasal region and discussed the clinical features observed during a 10-year follow-up period.Methods:We retrospectively reviewed hospital records for patients admitted due to rat bites.This study outlines the demographics,clinical features,and follow-up outcomes supported by comprehensive photo documentation of the patients’progress.Results:Twenty-five patients,with a mean age of 29 years,were admitted due to rat bites.Treatment was provided for three distinct types of injuries:nasal tip defect(type Ⅰ),nasal defect(type Ⅱ),and full-thickness nasal defect with loss of surrounding tissues(type Ⅲ).All patients recovered fully.Conclusions:The treatment for rat bites should be based on the wound type.The long-term follow-up outcomes are more favorable when fewer subunits of the nose affected.We recommend early surgical intervention,along with psychological therapy,to prevent interference with growth and development.展开更多
文摘Background In full-thickness nasal defects,the internal lining is perhaps the most challenging aspect of the three layers to rebuild.Nasal damage is usually more concentrated on the tip,soft triangles,alar wings,and columella,but the lateral nasal arteries are often left intact and the damage to the dorsal sidewalls are normally superficial.Methods Twelve patients who required total nasal reconstruction received a forehead flap placement as external coverage and autologous rib cartilage as structural support.Residual normal/superficial scar tissue flaps on the dorsal sidewalls with lateral nasal artery pedicles were mobilized and designed for internal lining repair without creating secondary donor site damage.The flaps were then turned 180°downward and placed between the alar medial angles and the fornix.Results No total lining flap necrosis occurred in all the patients.Partial necrosis occurred on the distal edge owing to overpressure of the nostril splint to the flaps;however,the wounds eventually healed,and the nasal structural integrity was preserved.The patients were satisfied with the aesthetic results and had no complaints of airway stenosis.Conclusions Lateral nasal artery pedicle dorsal sidewall skin flaps are appropriately thick,providing enough nostril circumferential support to improve airway stenosis.It allows sufficient blood supply and creates no extra donor site damage.Blood vessels and skin flaps are often undamaged,thereby allowing maximum application in total nasal reconstruction.
基金supported by the National Natural Science Foundation of China(grant no.82272289).
文摘Background:Nasal defects due to rat bites are frequently encountered in rural regions of China.In addition to serving as disease vectors,rats can also inflict bite injuries.In this study,we delineated the characteristics of rat bite injuries in the nasal region and discussed the clinical features observed during a 10-year follow-up period.Methods:We retrospectively reviewed hospital records for patients admitted due to rat bites.This study outlines the demographics,clinical features,and follow-up outcomes supported by comprehensive photo documentation of the patients’progress.Results:Twenty-five patients,with a mean age of 29 years,were admitted due to rat bites.Treatment was provided for three distinct types of injuries:nasal tip defect(type Ⅰ),nasal defect(type Ⅱ),and full-thickness nasal defect with loss of surrounding tissues(type Ⅲ).All patients recovered fully.Conclusions:The treatment for rat bites should be based on the wound type.The long-term follow-up outcomes are more favorable when fewer subunits of the nose affected.We recommend early surgical intervention,along with psychological therapy,to prevent interference with growth and development.
