外鼻肿物34例的临床分析
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南京医科大学第一附属医院

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项目编号为“白求恩·医学科学研究基金项目2023年第006号基金支持课题”,课题编号2023YWZJ006-ym


Clinical analysis of 34 cases of external nasal mass
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The First Affiliated Hospital, Nanjing Medical University

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    目的: 探讨外鼻肿物的临床流行病学特点,分析切除后缺损的修复方法及临床效果。方法: 回顾性分析2010年1月-2020年12月我院收治的34例外鼻肿物,分析肿物的发病部位、大小、病理类型、手术和修复方法等.结果:本组患者,男女发病比例为 1.125:1,男女发病率差异无统计学意义(P>0.05); 外鼻恶性肿瘤中,基底细胞癌最多(16例,80%),各年龄层均有发病,恶性肿瘤的发病高峰年龄为60岁以上老年人群(15例,75%)。术中彻底切除肿物后,选择直接缝合15例,邻近皮瓣修复7例,转移鼻唇沟皮瓣修复10例,植皮2例。术后随访1例接受放化疗,2例接受单纯化疗。28例伤口一期愈合,鼻外观基本对称,鼻腔无明显通气功能障碍。1例行二期疤痕修复。3例失访,3例死亡(死于老龄),2例对外鼻形态不满意。结论: 外鼻肿物切除彻底很少复发,一般无需放化疗。在手术彻底切除肿瘤的基础上,依据缺损部位及程度灵活应用不同的修复方法,重建鼻部轮廓,保持鼻部外形及结构的完整性。其中鼻唇沟皮瓣修复操作方便,并发症少,患者取得满意效果,是我们常选择的治疗方案。

    Abstract:

    Objective: To explore the clinical epidemiological characteristics of external nasal cutaneous tumors, and introduce the repair methods of local skin defect after external nasal mass resection, and explore the clinical effect for repair. Methods: Clinical data of 34 patients with external nasal mass in our hospital from January 2010 to December 2020 were analyzed retrospectively. To analyze the data included location, size and pathologic diagnosis of tumors, surgical incision and reconstruction method. Results: Of all the 34 cases, the male and female ratio was 1.125:1, the difference was statistically insignificant(P>0.05). Basal cell carcinoma was the most common malignant tumor(16 cases,80%). The peak age of malignant tumors was the elderly population over 60 years old(15 cases,75%). According to the defect, different repair were circumspectly designed (direct suture, n=15; local pedicle flap, n=7; nasolabial sulcus flap, n=10; dermatoplasty, n=2 ). All patients were followed up postoperatively. 1 case received chemoradiotherapy postoperatively. 2 cases received chemotherapy alone. In 28 cases, the nasolabial sulcus flap and autologous free skin graft were survived. The appearance of the nose was good without difficult ventilation. Scar was repaired in phase-two surgery. 3 cases were unavailable for follow up, and 3 cases died of oldness. 2 cases were not satisfied with the appearance of nose after operation. Conclusion: Once thoroughly resected, most of the tumors of external nose are barely relapsed, and radiotherapy or chemotherapy is unnecessary. On the basis of complete removal by surgery, according to the defect location and extent, flexible application of different repair methods can be used as in one-stage repairing of the defect of external nose, and reconstruct nasal contour, keep structural integrity and maintain the function of nose appearance. Among them, especially nasolabial sulcus flap repair method is convenient, satisfactory surgical results can be obtained.

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  • 收稿日期:2024-06-06
  • 最后修改日期:2024-07-21
  • 录用日期:2024-07-22
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