Combined, two-layered reconstruction technique for full-thickness nasal defects

The worked out technique of the reconstruction of full-thickness nasal defects consists in formation of three-layer plastic material based on skin-fascial flap, allogene cartilage and dermal transplantation. We have performed 13 operations, and all the patients have achieved acceptable clinical outcomes. The article presents the data on surgical wound healing, detection of the transplanted allocartilage, estimation of the cosmetic results by the visual analog scale.

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Reconstruction of the alae nasi by folded nasolabial flap

Acta chirurgica iugoslavica ◽

10.2298/aci0702029j ◽

2007 ◽

Vol 54 (2) ◽

pp. 29-32 ◽

Cited By ~ 2

Author(s):

M. Jovanovic ◽

M. Colic ◽

L. Rasulic ◽

M. Stojicic ◽

M. Malis

Keyword(s):

Skin Color ◽

Nasolabial Fold ◽

Full Thickness ◽

Nasolabial Flap ◽

Normal Breathing ◽

Step Procedure ◽

One Step ◽

Nasal Defects ◽

Alar Region ◽

Made In

Reconstruction of the nose is very old surgical procedure and, in fact, represents the beginnings of plastic surgery. In reconstruction, an effort has to be made in order to achieve a normal look. A surgeon must choose carefully the method of reconstruction, taking into consideration the skin color, texture and nasal topography. Full-thickness nasal defects in alar region are very difficult for reconstruction due to anatomic characteristics and structures, which are very important for normal breathing and cosmetic result. Our study analyzed 16 patients with full-thickness defect of alae nasi. Folded nasolabial flaps were used for reconstruction of these defects. Good results were achieved in all cases. The flap was vital. No flap necrosis was reported in any of these patients. The lining of the nose was good. Postoperatively, the alar edge was thickened, but it became thinned after six months. The incision in donor?s region was well placed in the natural line of nasolabial fold. It was concluded that folded nasolabial flap was extremely good one-step procedure for reconstruction of full-thickness defects of alar region. .

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Interpolated subcutaneous tissue pedicle melolabial flap for internal lining in full-thickness nasal defects

The Laryngoscope ◽

10.1002/lary.22306 ◽

2011 ◽

Vol 121 (S5) ◽

pp. S350-S350

Author(s):

Garrett R. Griffin ◽

Douglas B. Chepeha ◽

Jeff S. Moyer

Keyword(s):

Subcutaneous Tissue ◽

Full Thickness ◽

Internal Lining ◽

Nasal Defects

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Facial Artery Musculomucosal (FAMM) flap for nasal lining in reconstruction of large full thickness lateral nasal defects

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2015.08.008 ◽

2015 ◽

Vol 4 (4) ◽

pp. 351-354 ◽

Cited By ~ 4

Author(s):

Amin Rahpeyma ◽

Saeedeh Khajehahmadi

Keyword(s):

Facial Artery ◽

Full Thickness ◽

Nasal Defects

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Reconstruction of full thickness nasal defects following resection of skin malignancies and trauma: A single surgeon's experience

10.26226/morressier.5adde3c2d462b80290b592a4 ◽

2018 ◽

Author(s):

Baskaran Ranganathan

Keyword(s):

Full Thickness ◽

Nasal Defects

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The use of folded melolabial interpolation flaps to repair full thickness distal nasal defects: A review of technique and results

Journal of Surgical Dermatology ◽

10.18282/jsd.v1.i3.47 ◽

2016 ◽

Vol 1 (3) ◽

Author(s):

Eamonn Maher ◽

Scott Walen ◽

Ian Maher

Keyword(s):

Cartilage Graft ◽

Full Thickness ◽

Forehead Flap ◽

Common Site ◽

Paramedian Forehead Flap ◽

Surgical Teaching ◽

Mucosal Lining ◽

Cutaneous Flap ◽

Surgical Options ◽

Nasal Defects

The nose is a common site for skin cancer and there are several surgical options available for reconstruction after excision. Traditional surgical teaching suggests that in the case of a partial full thickness defect involving the distal nose or ala, a paramedian forehead flap (PMFF) or an intranasal lining flap with free cartilage graft and additional cutaneous flap should be performed. However, each of these options comes with unique disadvantages. The incision and pedicle required for the PMFF can be unsightly and functionally limiting, while the intranasal lining flap is technically challenging and can obstruct the nostril. Herein, we review our experience with a two-stage folded-over melolabial interpolation flap (MLIF) to repair partial full thickness defects of the distal nose and ala in order to recreate the cutaneous covering, nasal rim, and inner mucosal lining.

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Is reconstruction of composite defects of nose and cheek following tumor excision utilizing subunit principle the best?

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211563 ◽

2021 ◽

Vol 7 (5) ◽

pp. 721

Author(s):

Viresh Arora ◽

Faisal Ashfaq ◽

Atif Rafique

Keyword(s):

Wound Dehiscence ◽

Advancement Flap ◽

Nasal Reconstruction ◽

Full Thickness ◽

Lateral Migration ◽

Forehead Flap ◽

Nasal Defect ◽

Alar Retraction ◽

Simultaneous Reconstruction ◽

Nasal Defects

Background: Composite defects of nose and cheek are best stage reconstructed with separate nose and cheek flaps to recreate a blended nose-cheek junction, achieved by cheek advancement flap for cheek and forehead flap or local grafts for the nasal defect. This article analyses whether reconstruction of defects utilizing well-known subunit principle is cosmetically the best?Methods: Case records of fifteen patients of nasal cancers extension into the cheek from January 2011 to December 2015 were analyzed retrospectively.Results: Out of fifteen patients 8 were men and 7 women, two patients had SCC, rest had BCC. Average size of defect was 4.5 cm. Modified Imre’s cheek advancement flaps was used in all to reconstruct cheek defects while paramedian forehead flap was used for nasal reconstruction in 13 patients, skin graft and nasal advancement flap in one each. Eight patients underwent single stage reconstruction while seven with full thickness nasal defects had a delayed reconstruction. 13 patients rated their final appearance as satisfactory, while surgeon rated 12 patients with well-blended nose-cheek junction as satisfactory and lateral migration of junction being unsatisfactory. Alar retraction was observed in two patients with full thickness nasal defects. Two patients who underwent inner nasal lining reconstruction developed wound dehiscence while simultaneous reconstruction of nose and cheek was performed.Conclusions: Subunit principle application for composite nose and cheek results in symmetrical nose-cheek junction and appears excellent technique in achieving a satisfactory aesthetic outcome. Optimal results in full thickness nasal defects are achieved where reconstructing is delayed.

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THE TYPOLOGY OF EXTERNAL NOSE DEFECTS WITH LOSS OF THE CARTILAGE IN PATIENTS WITH SKIN TUMORS

Health and Ecology Issues ◽

10.51523/2708-6011.2015-12-3-3 ◽

2015 ◽

pp. 16-20

Author(s):

S. A. Ivanov ◽

L. A. Platoshkina ◽

N. M. Trizna

Keyword(s):

Single Step ◽

Point Of View ◽

Cartilage Defects ◽

Full Thickness ◽

External Nose ◽

Reconstructive Techniques ◽

Suggested Classification ◽

Predicted Risk ◽

Nasal Defects ◽

Reconstructive Methods

Objective: to substantiate the necessity to differentiate certain types of nasal defects with loss of the lower third nose cartilage. Material and methods. 121 patients with malignant neoplasm’s of the external nose having undergone radical surgery with single-step plastics of the lower third nose defect were included into the study. 35 of them (28.9 %) had cartilage loss. We used different reconstructive techniques to remove the skin defects, two-layer (skin + cartilage) and full-thickness defects. Results. From the technical point of view the most difficult was to remove unclosed full-thickness defects. The necessity was caused by the reconstruction of external and internal epithelial linings, missing cartilage and modeling of the nostril contour. Most of specific complications were revealed while removing the unclosed full-thickness defects. Conclusion . Full-thickness and two-layer (skin + cartilage) defects can be singled out among defects with loss of cartilage. In addition we divide full-thickness defects into defects with closed and unclosed contours. The suggested classification determines reconstructive methods and techniques and the predicted risk of complications.

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Paramedian forehead flap for nasal tip reconstruction after Mohs surgery

Journal of Surgical Dermatology ◽

10.18282/jsd.v1.i1.16 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Felipe Bochnia Cerci

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Surgical Planning ◽

Full Thickness ◽

Mohs Micrographic Surgery ◽

Forehead Flap ◽

Micrographic Surgery ◽

Nasal Tip ◽

Paramedian Forehead Flap ◽

Nasal Defects

The paramedian forehead flap is a great option for restoring complex nasal defects. Its main indications are large and deep wounds located on the distal third of the nose (tip and ala). For full-thickness defects, the paramedian forehead flap may be used alone or in combination with other methods. We presented a patient with a nodular basal cell carcinoma on the nasal tip and collumela treated by Mohs micrographic surgery and repaired with a paramedian forehead flap. Prior to reconstruction, it is essential that surgical margins are completely evaluated and free of tumor. For optimal paramedian forehead flap results, adequate surgical planning and meticulous technique are imperative.

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