A significant part of maxillofacial area traumas due to gunshot and mine-explosive injuries is total and subtotal defects of external nose. In this context, it is important to develop ways and methods for reconstruction of functional and aesthetic disorders in such patients.
OBJECTIVE
To improve treatment effectiveness of patients with total and subtotal defects of external nose caused by mine-explosive injuries.
PATIENTS AND METHODS
Study group included patients with total and subtotal external nose defects caused by mine-explosive injuries in battle areas, who were admitted to the hospital in the period from 3 to 8 months after the injury. Preoperatively, patients were performed computed tomography and 3D-model of complete external nose made of plastic material, which was glued over by Steri-strip, was created. The size and shape of defects were marked on the strips, which were then straightened, converting from 3D to 2D. Flap marking was carried out according to the obtained 2D-pattern, forming it on the ipsilateral side. The flap was rotated with reconstruction of cartilage framework and internal nasal cavity lining in a single step. Daily ischemia training was started 1 week after operation. The flap was dissected 3 weeks after its moving.
RESULTS
The number of patients equal 11 were operated in the period from 2021 to 2023. Complete flap engraftment was observed in all patients. The number of patients equal 2 had partial necrosis of the internal lining, so they underwent debridement under local anesthesia, and further regenerative process occurred by secondary healing. Donor areas healed without features. It has been determined, that simultaneous reconstruction of 3 external nose layers and flap dissection are possible 3 weeks after flap moving in 2 stages.
CONCLUSION
Two-stage reconstruction by paramedian flap, that provides the best aesthetic and functional results in a relatively short time, is effective treatment method of patients with total and subtotal external nose defect caused by mine-explosive and gunshot injuries.
