ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT CHỈNH HÌNH TỔN KHUYẾT MẤT CHẤT MŨI CÓ LIÊN QUAN ĐẾN CÁNH MŨI TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Background: Numerous surgical techniques exist for reconstructing tissue loss of the nose that involves the alar region, including local skin flaps, full-thickness skin grafts, composite grafts, pedicled flaps and free flaps. Operative outcomes vary according to the extent of injury and the method chosen for repairing nasal and alar defects. To provide a focused assessment of the effectiveness of reconstruction for alar-related defects, we conducted the study “Evaluation of surgical outcomes of reconstruction of nasal tissue defects involving the alar region at Cho Ray Hospital”. Materials and Methods: This prospective descriptive case-series included patients undergoing reconstructive surgery for nasal tissue loss involving the alar region in the Departments of Otorhinolaryngology and Plastic & Aesthetic Surgery, Cho Ray Hospital, from October 2014 to July 2015. Results: Among 21 patients, 9/21 had lesions confined to the alar region, whereas 12/21 had combined defects of other nasal sub-units; one patient had total loss of the nasal pyramid. Regarding technique, 17/21 defects were reconstructed with local flaps, 3/21 with auricular chondro-cutaneous composite grafts, and 1/21 with a free flap. Post-operatively, all patients achieved symmetry in alar base length and width; however, alar thickness remained unequal. Twenty of 21 patients had a modified Rhinoplasty Outcome Evaluation (ROE) satisfaction score > 50, with a mean of 75.4 ± 15.52. The mean satisfaction score improved by 42.86 points compared with pre-operative values. Conclusion: Surgery resulted in symmetrical alar base length and width on both sides. However, the thickness of the nose is still different because this unit tends to protrude higher than nearby units after reconstruction. The mean satisfaction score increased by 42.86 points post-operatively—an improvement of 2.3 times over the pre-operative score.