双葉皮弁を工夫した外鼻部分欠損の再建

摘要

We reconstructed a partial nasal defect located at the lower half of the nose using a bilobed island flap. The flap was well vascularized because the island pedicle included both the lateral nasal artery and nasal SMAS.Our method has several advantages compared to the conventional Zitelli's bilobed flap as follows: 1) the rotation arc of each island is increased 2) resection of the dog-ear which is essential when Zitelli's method is applied is eliminated, 3) a second lobe can be transferred as a swing flap or a V -Y advancement flap considering the aesthetic unit of the nose.The one disadvantage of this method is a trapdoor deformity which appears in the early phase of the post operative period although it usually subsided within six months of follow-up. The most suitable indication for this method is a partial defect of the lower one third of the nose less than 20 mm in diameter