연골피부 이개전방 유리피판 및 혈관 간치이식술을 이용한 코재건례 = Nasal Reconstruction with Chondrocutaneous Preauricular Free Flap and Interpositional Vascular Graft: A Case Report

다국어 초록 (Multilingual Abstract)

Purpose: Reconstruction of a full thickness defect of the nose is a difficult task for plastic surgeons because the anatomical characteristic, shape, and function of the nose all need to be taken into consideration. Most often, a local flap or a composite graft is used, but for a large defect, reconstruction using free flaps is the most ideal method. In free flap reconstruction, the chondrocutaneous preauricular area can be a suitable donor site. We performed a chondrocutaneous preauricular free flap with an interpositional vascular graft for reconstruction of a nasal ala.
Methods: A 46 year-old male presented to the hospital with a right alar deformity induced by a dog bite. During the surgery, the existing scar tissue was removed and thereby a newly formed full thickness defect was reconstructed using the chondrocutaneous preauricular free flap with an interpositional vascular graft harvested from the descending branch of the lateral femoral circumflex vessel between the facial and superficial temporal vessels of the free flap.
Results: The flap survived without flap loss and showed symmetry in its overall shape, contour, texture, and color. The patient was satisfied with the results and the surgery yielded no additional scars at the nasolabial fold area.
Conclusion: The chondrocutaneous preauricular free flap is a valuable method in reconstruction of full thickness defects of the nose, and using the descending branch of the lateral femoral circumflex vessel as the interpositional vascular graft at the anastomotic site produces reliable results. (J Korean Cleft Palate Craniofac Assoc 12: 111, 2011)

참고문헌 (Reference)

1 우경제, "이개기시부 유리피판을 이용한 단계적 양측 콧방울의 재건례" 대한성형외과학회 36 (36): 788-791, 2009

2 Zenn MR, "Use of the descending lateral femoral circumflex artery and vein for vascular grafting: a better alternative to an arteriovenous loop" 126 (126): 2010

3 Echo A, "Use of the descending branch of the lateral femoral circumflex vessels as a composite interposition graft in lower extremity reconstruction" 31 (31): 2011

4 Burget GC, "The subunit principle in nasal reconstruction" 76 (76): 1985

5 Houseman ND, "The angiosomes of the head and neck: anatomic study and clinical applications" 105 (105): 2000

6 Michlits W, "Nose reconstruction by chondrocutaneous preauricular free flaps: anatomical basis and clinical results" 113 (113): 2004

7 Zhang YX, "Extended applications of vascularized preauricular and helical rim flaps in reconstruction of nasal defects" 121 (121): 2008

8 Godina M, "Arterial autografts in microvascular surgery" 78 (78): 1986