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Файл:Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 334 - файл
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Nasal TIp
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Lower
1. A-T, V-T ap
2. Unilateral/bilateral advancement ap
Temple/Lateral Forehead
Small
1. Primary closure (along crow’s feet)
Medium
1. V-T ap
2. Rotation/transposition ap
3. Unilateral/bilateral advancement ap
4. Rhombic ap
5. Skin graft
Large
1. Multiple transposition aps
2. Rotation/transposition ap with skin grafting of secondary defect
3. Skin graft
4. Skin graft with Integra
5. Tissue expansion
®
485
Nose
Dorsum
Small
1. Primary closure (vertical/horizontal)
Medium
1. Glabella advancement ap
2. Glabella transposition ap
3. Skin graft
Nasal Tip
Small
1. Primary closure (vertical/horizontal)
486
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Medium
1. Glabella advancement ap
2. Bilobed ap
3. Skin graft
Columella
1. Primary closure
2. Skin graft
3. Two-stage melolabial ap
Side Wall
Small
1. Primary closure (vertical)
2. Healing by secondary intention
Medium
1. Skin graft
Algorithms forSpecic Sites
Upper Side Wall
1. Glabella transposition ap
Lower Side Wall
1. Bilobed ap
2. Apron ap
Ala
Small
1. Island advancement ap
Medium
1. Bilobed ap (laterally based)
2. Bilobed ap (medially based)
3. Two-stage melolabial ap
4. Apron ap
Paramedian Forehead Flap
1. Large nasal defects involving multiple nasal subunits
2. Large nasal tip defects
Lower Eyelid
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3. Large ala defects
4. Large dorsal defects
5. Large side wall defects
Eyelids
Upper Eyelid
Anterior Lamellar Defects
1. Primary closure (horizontal/vertical)
2. Advancement ap
3. Fricke ap
4. Skin graft
Full-Thickness Defects
Small
1. Primary closure (vertical)
Medium
1. Primary closure with lateral canthotomy and superior cantholysis
2. Tenzel ap
487
Large
1. Cutler beard ap
Medial Canthus
1. Healing be secondary intention
2. Glabella transposition ap
3. Glabella island ap
4. Skin graft
Lower Eyelid
Anterior Lamella Defects
Small
1. Primary closure (vertical)
2. Tear drop
488
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Medium
1. Advancement ap
2. Tripier ap
3. Rotation/transposition ap
Large
1. McGregor ap
2. Mustarde’ ap
Algorithms forSpecic Sites
Full-Thickness Defects
Small
1. Primary closure
Medium
1. Primary closure with lateral canthotomy and inferior cantholysis
2. Tenzel ap
Large Defects
1. Hughes ap
2. Macgregor ap
3. Mustarde’ ap
Ear
Concha
Partial Thickness
1. Healing by secondary intention
2. Skin graft
Partial Thickness/Full Thickness
1. Revolving door ap
2. Post-auricular artery island ap
3. Post-auricular transposition ap
4. Pre-auricular transposition ap
Cheek
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Antihelix/Helix
Partial Thickness
1. Healing by secondary intention (antihelix)
2. Skin graft (antihelix)
Full Thickness
1. Wedge excision
2. Helical rim advancement
3. Two-stage post-auricular ap
Triangular Fossa
1. Healing by secondary intention
2. Skin graft
3. Superiorly based pre-auricular ap
Tragus
1. Superiorly based pre-auricular ap
2. Advancement ap
489
Posterior Surface ofPinna
1. Healing by secondary intention
2. Primary closure
3. Skin graft
4. Post auricular advancement/transposition ap
5. Rhombic ap
Lobule
1. Primary closure
Cheek
Medial
Small
1. Primary closure
490
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Medium
1. Island advancement ap
2. Rotation/transposition ap (lateral)
3. Rotation/transposition ap (Inferior)
Buccal
Small
1. Primary closure
Medium
1. Primary closure
2. Rhombic ap
3. Rotation/transposition ap (lateral)
4. Rotation/transposition ap (inferior)
5. Island advancement ap
6. Bilobed ap
Zygomatic Unit
Algorithms forSpecic Sites
Small
1. Primary closure
Medium
1. Rhombic ap
2. Rotation/transposition ap
3. Mustarde’ ap
Mandibular
Small
1. Primary closure
Medium
1. Rhombic ap
2. Rotation/transposition ap
3. Bilobed ap
Lips
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Lateral Unit
Small
1. Primary closure
Medium
1. Asymmetric primary closure
2. Rhombic ap
3. Rotation/transposition ap
4. Bilobed ap
Lips
Lower Lip
Skin Only
Small
1. Primary closure (along rhytids)
2. M/W closure
491
Medium
1. A-T ap
2. Inferiorly based nasolabial ap
3. Superiorly based nasolabial ap
Mucosa Only
Small
1. Primary closure
Medium/Large
1. Mucosal advancement ap
Full-Thickness Defect
Small
1. Primary closure
2. W excision
Medium
1. Bilateral advancement ap (Commissurotomy)
2. Karapandzic ap
3. Abbe ap
4. Abbe– Estlander ap
492
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Large Defects
1. Bilateral advancement ap (Commissurotomy)
2. Karapandzic ap
3. Karapandzic ap + Abbe ap
4. Fan ap
Upper Lip
Skin Only
Small
1. Primary closure
2. A-T ap
Medium
1. Laterally based rotation/transposition ap
2. Unilateral/bilateral perialar crescentic advancement ap
3. Island advancement ap
4. Inferiorly based nasolabial ap
Full Thickness
Algorithms forSpecic Sites
Small
1. Primary closure
Medium
1. Perialar crescentic advancement ap
2. Karapandzic ap
3. Abbe ap
4. Abbe–Estlander ap
Large
1. Bilateral nasolabial ap + Abbe ap
Upper/Lower Lip (Chronic Ulcers/Atrophy)
Nanofat injection
Posterior Neck
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Chin Defects
Small
1. Primary closure
Medium
1. V-T ap
2. Rotation ap
3. Bilobed ap
4. Rhombic ap
Neck
Central Neck
1. Primary closure
2. O-Z ap
3. Rhombic ap
Lateral Neck
493
1. Primary closure
2. O-Z ap
3. Rotation/transposition ap
Posterior Neck
1. Primary closure
2. O-Z ap
3. Rotation/transposition ap
Index
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A
Abbe-Estlander ap, 399, 437
Abbe ap, 397, 409, 434, 441, 491
Accessory nerve, 20
Advancement aps
bilateral, 45, 46, 112, 132, 150, 395, 404,
415, 419
island, 45, 59, 195, 424
rotation, 343, 347
unilateral, 45, 110, 130, 150, 415, 419, 439
Aesthetic borders, 23, 29, 33, 51, 328, 376
Aesthetic subunits, 25
Aesthetic units, 23, 25, 375
Algorithms
auricle/pinna, 488–489
cheek, 373–374
chin, 493
eyelid, 487–488
forehead, 484–485
lips, 491–493
neck, 493
nose, 485–487
scalp, 483–484
Anterior lamella, 215, 218, 235, 254
Antihelix/helix, 282, 286–302
helical rim advancement, 264,
286–302, 304
lobule, primary closure, 322
partial thickness defect
healing by secondary intention, 312
skin graft, 264, 304
superiorly based pre auricular
transposition ap, 280, 304
posterior surface pinna
advancement ap, 290, 299
healing by secondary intention, 312
post auricular advancement/
transposition ap, 315, 318
primary closure, 312
rhombic ap, 320
skin graft, 312
tragus
advancement ap, 308
transposition ap, 318
triangular fossa
healing by secondary intention, 304
skin graft, 304
superiorly based pre-auricular
ap, 304
two stage post auricular ap, 302
wedge excision, 286, 390, 393
Anti tragus, 280, 299
Apron ap, 190
A-T ap, 128, 138
Auricle/pinna
anatomy, 16
local anaesthesia, 17
nerve supply, 17
Auriculotemporal nerve, 9, 10, 16, 18, 76
B
Bilateral advancement ap, 45, 46, 132
Bilateral fan ap, 411, 412
Bilateral perialar crescentic advancement
ap, 439
Bilobed ap, 51, 104, 176, 184, 187, 198,
200, 370
Buccal subunit, 29, 328, 339–347
Burrow’s triangles, 45, 110, 112, 126, 132,
136, 142, 145, 150, 152, 154, 169
C
Cantholysis (inferior), 243, 247
Cantholysis (superior), 231
Canthotomy (lateral), 231, 243, 247, 251
Cavum concha, 264–280
© Springer Nature Switzerland AG 2024
V. Ilankovan et al., Local Flaps in Facial Reconstruction,
https://doi.org/10.1007/978-3-031-49464-2
495
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