PDF(Pubmed)
Abstract：
BACKGROUND The columella has many fundamental functions, such as nasal breathing and support of the nasal tip, in addition to the aesthetic role it plays. The columella is one of the most difficult nasal subunits, both from the point of view of disease control and from that of reconstruction. Lesions involving the columella can be difficult to control, and malignancies can spread to the septum, subcutaneous tissues of the lip, and floor of the nasal cavities. Many columella reconstruction methods after resection have been proposed (local nasal flaps, skin grafts, regional flaps, free flaps), depending on the size of the defect, patient\'s features, surgeon\'s experience, and patient\'s aesthetic wishes. CASE REPORT We present a case of an 82-year-old woman with various comorbidities who had squamous cell carcinoma (G2) originating from the skin of the right side of the columella. The lesion infiltrated the cartilage, arriving to the skin of the columella on the left side and extending to the mucosa of the nasal septum bilaterally. Reconstruction was conducted using a bilateral nasolabial flap, with good functional and aesthetic result. Surgical revision for the autonomization of pedicled flaps was not necessary, nor desired by the patient. CONCLUSIONS The bilateral nasolabial flap is an effective and safe solution for reconstructing the columella, with good support of the tip even without cartilaginous graft. This technique is especially feasible in elderly patients and those with concomitant pathologies, who benefit from rapid healing of the wound.
摘要：
背景技术小柱具有许多基本功能，例如鼻呼吸和鼻尖的支撑，除了审美的作用。小柱是最困难的鼻腔亚单位之一，从疾病控制和重建的角度来看。涉及小柱的病变可能很难控制，恶性肿瘤可以扩散到隔膜，嘴唇的皮下组织，和鼻腔的地板。已经提出了许多切除后的小柱重建方法（局部鼻皮瓣，皮肤移植,区域襟翼,自由襟翼),根据缺陷的大小，患者的特征，外科医生的经验，和病人的审美愿望。病例报告我们介绍了一例82岁女性，患有各种合并症，她患有源自小柱右侧皮肤的鳞状细胞癌（G2）。病变浸润软骨,到达左侧小柱的皮肤，并向两侧延伸至鼻中隔的粘膜。使用双侧鼻唇沟皮瓣进行重建，具有良好的功能和美学效果。没有必要对带蒂皮瓣进行手术翻修，也不是病人所希望的。结论双侧鼻唇沟皮瓣是重建小柱的有效和安全的解决方案。即使没有软骨移植物，也能很好地支撑尖端。这种技术在老年患者和伴有病理的患者中特别可行，从伤口的快速愈合中受益。
