Clinical Application Of Nasolabial Flap Pedicled With Angular Artery In Repairing Nasal Defects Of Multiple Subunits

Objective:In the past,nasolabial flap was thought repair nasal defects only in one to two subunits,this article aim to investigate the possibility and effect of the angular artery pedicled nasolabial flap for reconstruction of nasal defects of multiple subunits.Methods:From September 2014 to June 2016,Department of Plastic Surgery of the 1st Affiliated Hospital of Jilin University,30 cases of nasal defects in multiple subunits were repaired with the angular artery pedicled nasolabial flap,There were 17 male patients and 13 female patients with a mean age of 47.6 years(range,36-63 years).23 cases of nasal defects were caused by trauma and other defects were caused by excision of tumor.The nasal defect size ranged from 2.0cm×1.7cm to 5.0cm×3.5cm,with more than three subunits.All defects were reconstructed with angular artery pedicled nasolabial flap,the flap size ranged from 2.5 cm × 2.0 cm to 7.5 cm × 3.5 cm.Six patients required cartilage grafts for alar rim support.The donor sites were sutured directly.Results:All flaps survived,incision at donor and accepted sites healed by first intention.The mild venous stasis at the distal end of 2 flaps occurred in 24 hours postoperatively and alleviated spontaneously.Flap revision was performed in 25 cases after 3-6 months.23 cases were followed up 3-12 months.All patients achieved satisfactory results in nasal appearance,flap texture and color,and ventilatory function.No obvious scar was found at donor sites,bilateral symmetry.Conclusion:The angular artery pedicled nasolabial flap can repair the nasal defects of multiple subunits and it has a reliable blood supply and flap survival rate,the texture,color and thickness are similar to the surrounding skin,no obvious scar was found at donor sites.It is one of the effective methods to repair multiple subunits of nasal defects.