Abstract：Objective This study aimed to investigate the application effect of subcutaneous pedicle flap of narrow pedicle nasolabial fold on the repair of facial defects after resection of nasal and paranasal malignant tumors. Methods A retrospective cohort study was conducted. From June 2018 to June 2022, 40 patients were admitted to the Department of Plastic Surgery of the First Affiliated Hospital of Bengbu Medical College for defect repair after resection of malignant tumors of the nasal and paranasal body surface. Among them, 13 were males and 27 were females, aged 52-93 (69±12) years. According to the different treatment methods, the subjects were divided into two groups: the control group involving 20 cases using traditional local flap repair, and the observation group involving 20 cases repaired by narrow pedicle nasolabial fold subcutaneous peduncular flap. The clinical baseline data of the two groups were observed and compared. These data included perioperative indicators such as flap area, flap peduncle width, ratio of flap area to peduncle width, operation time, intraoperative blood loss, flap survival rate, direct suture rate of donor valve, Vancouver scar scale (VSS) score, incision infection, subflap effusion, postoperative hemorrhage, stretching of surrounding tissues, and "cat ear" formation of pedic. Results No significant differences existed in the baseline data of age, sex, tumor nature, size, location and length of hospital stay between the two groups (all P values >0.05). The flap area was (6.90±1.94) cm2 in the observation group and (7.80±2.24) cm2 in the control group, and there was no significant difference between the two groups (t=1.36, P=0.182). The width of the flap pedicle was (0.98±0.29) cm, the ratio of flap area to pedicle width was 7.35±2.75, the operation time was (70.5±16.7) min, and the intraoperative blood loss was (47.5±8.5) mL in the observation group, and those were(2.93±0.65) cm, 2.75±0.82, (83.5±19.9) min, and (60.5±15.0) mL in the control group, respectively, and the differences were statistically significant between the two groups (t=12.25, 7.17, 2.24, 3.36; all P values <0.05). The survival rates of flaps in the observation and control groups were 95.0% (19/20) and 90.0%(18/20), respectively, and the difference was not statistically significant (χ2=0.00, P=1.000). The direct suture rate of the donor valve area in the observation group (95.0%, 19/20) was significantly higher than that in the control group (60.0%, 12/20), and the difference was statistically significant (χ2=5.16, P=0.023). The VSS score of vascular circulation in the observation group was (1.40±0.99) and (1.65±0.81) in the control group, and the difference was not statistically significant (t=0.87, P=0.388). The color, softness, thickness scores, and VSS scores in the observation group were (0.90±0.64), (2.00±1.03), (1.30±0.92), and (5.60±3.27) scores, respectively, which were lower than those in the control group (1.45±0.76), (2.65±0.81), (1.95±0.89), and (7.70±2.66) scores, respectively, and the differences were statistically significant (t=2.48, 2.22, 2.27, 2.23; all P values were <0.05). There were 7 cases and 14 cases of postoperative flap traction between the observation group and the control group, and 5 and 16 cases of cat ear formation in the posterior pedicle, respectively, and the differences between the groups were statistically significant (χ2=4.91, 12.13; all P values <0.05). There was no significant difference in the incidence of postoperative incision infection, bleeding and subcutaneous fluid accumulation between the two groups(all P values >0.05). Conclusion Treatment of peduncle and donor flap is better than the traditional local adjacent-flap translocation repair of the soft-tissue defect wound of nasal and paranasal malignant tumors by using the subcutaneous pedicle flap of the narrow pedicle nasolabial fold. Treatment of peduncle and donor flap can effectively shorten the operation time, reduce the amount of bleeding, improve the aesthetics of the postoperative flap, and reduce the occurrence of complications.
李旭文, 葛秀玉, 宋培军, 徐静. 窄蒂鼻唇沟皮下蒂皮瓣在鼻部及鼻旁恶性肿瘤切除后创面修复中的应用[J]. 中华解剖与临床杂志, 2023, 28(8): 527-532.
Li Xuwen, Ge Xiuyu, Song Peijun, Xu Jing. Application of subcutaneous pedicle flap of narrow pedicle nasolabial fold in wound repair after resection of nasal and paranasal malignant tumors. Chinese Journal of Anatomy and Clinics, 2023, 28(8): 527-532.
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2023, Vol. 28 
