Reconstruction of nasal alar and columella defect

The nose and the nasal column are damaged due to trauma or infection, etc., and the restoration surgery must be based on the location, size and shape of the defect. Treatment of diseases: nasal traumatic nasal bone fracture Indication 1. Defects above the nose. 2. A defect in the edge of the nose. 3. Nasal column defect. Preoperative preparation Shave the hair in the field and shave the beard. Surgical procedure (1) Defects above the nose 1. Excision of the scar removes the collapsed scar and cuts the lower skin to relax, then pulls it down to make it symmetrical to the opposite side. 2. Skin grafting Take a piece of full-thickness skin, transplant it on the wound surface, carefully suture it, and pack and pressurize it to fix it. After 12 days, the package can be unpacked. (B) the nose wing defect This defect is often full thickness, and includes the alar cartilage. The ear wheel tissue is the most ideal material for composite grafts. It can be completed in one time, and its quality, thickness, elasticity and color are very similar. If the width of the required graft is less than 1.5cm, the deformation of the ear shell is not introduced. People pay attention. After the transplanted tissue survives, there is generally no contraction. 1. Remove the scar at the defect and cut the lower part of the defect, and turn it down into the nasal cavity. It can be used as a partial lining and at the same time achieve the purpose of expanding the contact surface of the tissue, so that the graft is easy to survive. 2. Cut the composite tissue of the outer edge of the ear shell, and carefully measure the size of the tissue taken beforehand, which is often slightly larger than necessary. The tissue is cut to the required size, and then the missing part of the ear wheel is relatively sutured, and the ear shell is slightly smaller after surgery. Women are covered by long hair and have no aesthetic consequences. 3. Remove the ear wheel tissue and carefully suture it at the defect. The inner skin and nasal vestibular skin are sutured. But the cartilage is not sutured, the outer skin is finally sutured, the nasal vestibule is blocked with oil iodoform gauze, the wound outside the nose is covered with oil gauze, and the impression is pressed with impression glue to prevent infection. The internal and external compression is the survival of the graft. The essential. If edema occurs, necrosis may occur. The dressing will start 1 week after surgery. If the graft is dark red, it will gradually turn bright red within 2 to 4 days. It indicates that it has survived, and after 10 days, the filled gauze is taken out, and the stitching can be later. If the nasal wing defect is large, it is estimated that it is difficult to repair with the composite structure of the ear wheel. A full-thickness flap can be cut over the defect, flipped down, and the lower end folded into the lower edge of the nose, and then the free flap is used to fill the wound. And pressure bandage. This method may leave a color difference on the nose, the effect may not be ideal, but it is also one of the effective methods of plastic surgery. (3) Nasal column defects The nasal column defects may be limited to small columns, or may be complicated by septal defects. The methods for their reconstruction are also different, as follows: 1. The simplest and most ideal method for partial defect of the nasal column and complete resection of the septum is to take the repair of the ear wheel tissue. (1) Cut the skin of the nasal column defect to increase the width and contact surface of the wound. (2) Take a tissue without the cartilage, length and size, from the lower part of the ear wheel or the earlobe, and suture the wound at the ear wheel. (3) The ear wheel tissue is stitched to the residual wound surface of the split nasal column, and is protected and fixed with gauze, and the seam is removed after 12 to 14 days. 2. Nasal column defect and septal defect reconstruction due to septal defect, can not be repaired with free tissue, you can use nasolabial fold small skin tube to repair. This procedure is more suitable for older people with looser skin. (1) At one nasolabial fold, make a skin tube of similar length and size to the nasal column. The direction can be from the outside of the nose to the corner of the mouth. (2) After 3 to 4 weeks, cut the lower end and transplant it to the remaining part of the tip of the nose. (3) After 3 to 4 weeks, the upper end of the sheath is cut and transplanted to the old base of the upper lip. (4) After 10~12d, the line can be restored, and the original shape of the small column can be restored.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.