๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Flap design
Flap design
Loss of muscle in the nasal ala reduces structural support, and a cartilage graft is often required to prevent nasal valve collapse, maintain airway patency, prevent contraction of the alar rim, and provide bulk to restore the natural alar convexity.2 Pushing against the alar rim to detect resistance and watching for alar collapse as the patient inspires can be helpful to gauge the need for additional support.2 If vestibular lining is required, the flap can be designed to fold over onto itself, though a PFF may be better suited for these larger, full-thickness defects. A template is made of the defect, often using the contralateral ala as a reference. The template is then rotated onto the cheek so that the superior portion lies along the melolabial fold and the inferior portion lies laterally. Burowโs triangles are drawn above and below the template to create an ellipse. Flap reach is confirmed with a suture or stretched gauze, ensuring that neither is stretched too tightly. Always overestimate flap length.