Cangkok Aurikular Kondrokutaneus Komposit sebagai Alternatif untuk Rekonstruksi Defek Dorsum Nasal dengan Ketebalan Penuh Ketika Septal Hinge Flap Tidak Tersedia: Laporan Kasus
DOI:
https://doi.org/10.35790/msj.v7i1.54926Abstract
Abstract: Nose is an important structure of the face because it is centrally located and prominent, however, it is also weak and vulnerable to trauma. Nasal trauma, if not treated properly, can lead to functional and esthetic deformities. A full-thickness defect in dorsum nasal and septal area, caused by a traffic accident, can present a challenging reconstruction scenario. We present a case of a 21-year-old male with full-thickness defect in the dorsum nasal and septal area due to a traffic accident. The septal hinge flap is a common option for cartilage and lining reconstruction, but it may not always be available. Considering the complexity of the defect, we decided to perform a reconstruction using an auricular chondrocutaneous graft. A series of post-operative follow-ups were carried out from two months to four months postoperatively to evaluate in depth the function and aesthetic aspects of the patient. The results of the evaluation conducted showed that the patient had achieved a high level of satisfaction related to the restoration of his function and aesthetic appearance. This evaluation was essential to ensure that the interventions carried out had been functionally and aesthetically successful.
Keywords: nasal fracture; nasal reconstruction; full-thickness graft; auricular graft; septal hinge flap
Abstrak: Hidung merupakan struktur penting pada wajah karena letaknya di tengah dan menonjol, namun, struktur ini juga lemah dan rentan terhadap trauma. Trauma hidung, jika tidak ditangani dengan baik, dapat menyebabkan kelainan bentuk baik fungsional maupun estetika. Defek dengan hilangnya ketebalan penuh pada area dorsum hidung dan septum, yang disebabkan oleh kecelakaan lalu lintas, dapat menghadirkan skenario rekonstruksi yang menyulitkan. Kami menyajikan laporan kasus seorang laki-laki berusia 21 tahun dengan defek ketebalan penuh pada area dorsum nasal dan septum akibat kecelakaan lalu lintas. Septal hinge flap ialah pilihan umum untuk rekonstruksi tulang rawan dan lapisannya, tetapi mungkin tidak selalu tersedia. Dengan mempertimbangkan kompleksitas defek tersebut, diputuskan untuk melakukan rekonstruksi menggunakan cangkok aurikular kondrokutaneus. Serangkaian tindak lanjut pasca-operasi dilakukan sejak dua bulan hingga empat bulan pasca operasi untuk mengevaluasi secara mendalam aspek fungsi serta estetik pada pasien. Hasil evaluasi menunjukkan bahwa pasien telah mencapai tingkat kepuasan tinggi terkait dengan pemulihan fungsi dan penampilan estetiknya. Evaluasi ini sangat penting untuk memastikan bahwa intervensi yang dilakukan telah berhasil secara fungsional dan estetis.
Kata kunci: fraktur nasal; rekonstruksi hidung; full-thicknes graft; auricular graft; septal hinge flap
References
Kim L, Huddle MG, Smith RM, Byrne P. Facial Trauma Surgery. Nasal Fractures. Facial Trauma Surgery. 2019. p. 122-8. Available from: doi.org/10.1016/B978-0-323-49755-8.00018-9
Steitz JT, Hajnas NM, Toriumi DM. Revision rhinoplasty. Youman & Winn Neurological Surgery (7th ed). Elsevier; 2017. p. 544-57.
Marcus BC, Wang TD. Management of the post-traumatic nasal deformity. In: Bailey BJ, Johnson JT, Newland SD, editors. Head and Neck Surgery - Otolaryngology (4th ed) Vol I. Philadelphia: Lippincott Williams and Wilkins; 2006. p. 2580-93.
Astaraki P, Baghchi B, Ahadi M. Diagnosis of acute nasal fractures using ultrasound and CT scan. Annals of Medicine and Surgery edisi 78. 2022. 103860 doi: 10.1016/j.amsu.2022.103860
Reilly PL, David J. David. Craniofacial injuries. Youman & Winn Neurological Surgery E-book (7th ed) Chapter 355. Elsevier; 2017. p. 2952-70.
Wei JJ, Tang ZL, Liu L, Liao XY, Yu YB, et al. The management of naso-orbital-ethmoid (NOE) fractures. Chinese Journal of Traumatology (CJT). 2015;18(5):296-301. Doi: 10.1016/j.cjtee.2015.07.006
Westerveld GJ, Middelweerd RJ, Leemans CR. The hinged-door composite septal flap as structural support and lining of nasal reconstruction by a forehead flap. Rhinology. 2001;39(1):5-8. Available from: https://www.rhinologyjournal.com/Abstract.php?id=41
Cerci FB, Dellatorre G. Paramedian forehead flap combined with hinge flap for nasal tip reconstruction. An Bras Dermatol. 2016;91(5 suppl1):140-3. Doi:10.1590/abd1806-4841.20164583
Yen CI, Kao HK, Chang CS, Huang CJ, Chen HC, Yang SY, et al. Simultaneous free flap and forehead flap for nasal reconstruction. Microsurgery. 2023;43(5):470-5. Doi:10.1002/micr.31020
Cherubino M, Battaglia P, Turri-Zanoni M, Tamborini F, Giudice M, et al. Medial femoral condyle free flap for nasal reconstruction: new technique for full-thickness nasal defects. Plast Reconstr Surg Glob Open. 2016;4(9):e855. Doi:10.1097/GOX.0000000000000858
Itoh Y, Arai K. Nasal reconstruction with a thin, free flap prefabricated with a silicone sheet: case report. J Reconstr Microsurg. 1992;8(5):359-62. Doi:10.1055/s-2007-1006718
Austin GK, Shockley WW. Reconstruction of nasal defects: contemporary approaches. Curr Opin Otolaryngol Head Neck Surg. 2016;24(5):453-460. Doi:10.1097/MOO.0000000000000295
Rocha JLS, Cavalieri-Pereira L, Brancher GQB, Altafin L, Cerezetti L, Mirandola C. Treatment of naso-orbito-etmoidal type III fracture in adolescents case report. Int J Odontostomat. 2020;14(2): 167-71. Doi:10.4067/S0718-381X2020000200167
Lee JY, Seo JH, Jung SN, Seo BF. Chondrocutaneous posterior auricular artery perforator free flap for single-stage reconstruction of the nasal tip: a case report. Arch Craniofac Surg. 2021;22(6):337-40. Doi:10.7181/acfs.2021.00556
Etemadi MSh, Shahnaseri S, Soltani P, Motamedi MRK. Management of naso-orbito-ethmoid fractures: a 10-year review. Trauma Mon. 2017;22(3):e29230. Doi:10.5812/traumamon.29230
Liu W, Cao YL. Repair, grafting, and engineering of cartilage. Plastic Surgery Key. 2018. 261-284.e3 Available from: https//plasticsurgerykey.com/repair-grafting-and-engineering-of-cartilage/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Nico A. Lumintang, Sherly Tandililing, Nuzly Q. Akmal
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
COPYRIGHT
Authors who publish with this journal agree to the following terms:
Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal.
Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal.
Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
