scholarly journals Technique for Reconstruction of Nasal Alar Defects in Asian Patients with a Modified Bilobed Nasolabial Flap

2021 ◽  
pp. 1-3
Author(s):  
Priya Tiwari ◽  
Priya Tiwari ◽  
Ong Wei Chen ◽  
TC Lim ◽  
Lim Jane
Keyword(s):  
Nasal Reconstruction ◽  
Nasolabial Fold ◽  
Nasolabial Flap ◽  
Pivot Point ◽  
Nasal Tip ◽  
Bilobed Flap ◽  
Asian Patients ◽  
Alar Retraction ◽  
The Aesthetic ◽  
Secondary Lobe

Introduction: The Oriental nose differs from the Caucasian nose in terms of size, subunit definition, texture, and thickness of the skin [1]. Zitelli’s bilobed flap enables aesthetic reconstruction in Caucasian noses but in smaller Oriental noses the outcomes are less desirable with nasal alar retraction commonly seen [2]. Hence, we describe a modification of Zitelli’s bilobed flap incorporating nasolabial skin for a single stage nasal reconstruction with reduced nasal alar retraction [3]. Methods: We modified the bilobed flap based on Zitelli’s bilobed flap and the aesthetic subunit principle, as modified for Orientals by Yotsuyanagi in 2000 [4]. The primary lobe was located between the defect and the cheek and the second lobe was located on the cheek, above the nasolabial fold. The modification of the bilobed flap was designed to have a primary lobe that was 10% longer than the length of the distal defect edge from the flap’s pivot point, and the width of the primary lobe was equal to the width of the defect. The length of the secondary lobe was 130% of the length of the distal defect edge to the flap’s pivot point, and the width of the secondary lobe was two-thirds the width of the primary lobe. Results: Satisfactory alar reconstruction was achieved from the viewpoint of the patient and surgeon. There was good nasal contour and appropriate symmetry of the nasal tip with reduced nasal alar retraction. Conclusion: The modification of Zitelli’s bilobed flap to have a longer primary lobe and include nasolabial skin, results in reduced nasal alar retraction.

Geometric Analysis of the Bilobed Flap for Nasal Reconstruction Surgery

FACE ◽  
2021 ◽  
pp. 273250162199390
Author(s):  
Daniel Henick ◽  
Kelvin K. Ampem-Darko ◽  
Farah Sayegh ◽  
Paymon Sanati-Mezrahi ◽  
Mehul Bhatt ◽  
...  
Keyword(s):  
Geometric Analysis ◽  
Nasal Reconstruction ◽  
Anatomical Features ◽  
Reconstruction Surgery ◽  
Repair Technique ◽  
Bilobed Flap ◽  
Calculated Ratio ◽  
Flap Design ◽  
Objectively Measured ◽  
Angle Of Rotation

Background: Reconstruction of the nose can be difficult due to its complex anatomical features. In 1989, Zitelli described a modified version of the bilobed flap design technique using 45° and 90° angles to improve nasal reconstructions. While the bilobed flap is still frequently referenced in scholarly literature, there seems to be inconsistency in preoperative flap design; these deviations can lead to suboptimal outcomes. The authors aim to illustrate the variability in bilobed flap execution and provide guidelines in preoperative design to improve consistency. Methods: A geometrically-based approach was used to characterize the inconsistency of bilobed repair technique. The pre-operative design images from fifteen scholarly articles were analyzed via a series of measurements and computations to quantify the angle of rotation and dimensions for the primary and secondary lobes. The “Error Quotient” was a calculated ratio that objectively measured the extent to which a bilobed design deviated from Zitelli’s specifications. Results: There was a noticeable variability in the design of both the primary and secondary lobes. Bilobed designs with smaller angles of rotation, particularly of the first lobe, were associated with higher Error Quotients and greater amounts of deviation from Zitelli’s design. Designs with the smallest Error Quotients had a primary lobe rotation that approached 45°. Conclusion: Consistency of application of the bilobed flap should be established to allow for optimal results, particularly with emphasis on design of the primary lobe. This can be accomplished by including a disposable protractor and marker in their sterile kit to measure a 45° rotation.

Nasal sarcoidosis: a cause for a medical rhinoplasty?

2012 ◽  
Vol 126 (10) ◽  
pp. 1073-1076 ◽  
Author(s):  
J van Griethuysen ◽  
R Kuchai ◽  
A S Taghi ◽  
H A Saleh
Keyword(s):  
Cost Effective ◽  
Nasal Reconstruction ◽  
Nasal Deformity ◽  
Effective Technique ◽  
Nasal Bridge ◽  
Co Morbidity ◽  
Cost Effective Technique ◽  
History Of ◽  
The Aesthetic ◽  
Long Acting

AbstractObjective:We report the use of triamcinolone injections to correct severe nasal deformity due to sarcoidosis, as an alternative to formal surgical rhinoplasty.Case report:A 30-year-old woman with a long-standing history of sarcoidosis presented to a tertiary referral rhinology clinic complaining of breathing difficulty and nasal deformity. Flexible nasoendoscopy revealed red nasal plaques typical of nasal sarcoidosis, together with significant widening of the nasal bridge. Triamcinolone, a long-acting corticosteroid, was injected both intralesionally and subcutaneously over the nasal dorsum, at zero, three and eight months, resulting in long-lasting improvement of the nasal shape.Conclusion:Sarcoidosis is a non-caseating, granulomatous, epithelioid inflammation. Otorhinolaryngological manifestations occur in approximately 10 per cent of patients; however, there is little published experience of nasal reconstruction in such patients. We describe a quick, simple and relatively cost-effective technique, with little or no co-morbidity, with which to improve the aesthetic and symptomatic outcomes of nasal sarcoidosis.

Nasolabial Flap

2019 ◽  
pp. 307-316
Author(s):  
Michael Budd ◽  
Melissa Kanack ◽  
Michael Lee
Keyword(s):  
Donor Site ◽  
Nasal Reconstruction ◽  
Critical Component ◽  
Full Thickness ◽  
Nasolabial Flap ◽  
Younger Patient

The nasolabial flap is primarily used for nasal reconstruction and most frequently for full-thickness alar reconstruction due to the tissue’s location, texture, color, and bulk. The inferiorly based flap is most often used for alar reconstruction, while the superiorly based flap may also be used for nasal sidewall as well as alar reconstruction. Regardless of whether the flap will be superiorly or inferiorly based, the critical component of the patient marking is placement of the medial incision in the nasolabial or nasofacial crease. In the younger patient, consideration must be given to the donor site scar.

Auricular Sandwich Graft for Caudal Septal Augmentation

1986 ◽  
Vol 3 (4) ◽  
pp. 27-31
Author(s):  
Julius Newman ◽  
Abram Nguyen ◽  
Roger Anderson
Keyword(s):  
Surgical Procedure ◽  
Donor Site ◽  
Obtuse Angle ◽  
Nasal Reconstruction ◽  
Nasal Dorsum ◽  
Cartilage Graft ◽  
Nasal Tip ◽  
Aesthetic Results ◽  
Conchal Cartilage Graft ◽  
Primary Phenomenon

Retraction of columella and collapse of nasal tip may be a primary phenomenon or secondary to poor results of rhinoplasty. This may be due to excessive resection of dorsocaudal septum or inappropriate removal of the nasal spine. Reconstruction of the columella is a difficult surgical procedure and many techniques have been described. This report describes a technique of interposition of a composite skin-conchal cartilage graft between the caudal septum and columella. The graft will restore the projection of the nasal tip and correct a retracted columella by increasing its base. The newly positioned columella forms an aesthetically acceptable obtuse angle with the lip and is 2–3 mm lower than the alar rims. The cartilage from the concha of the ear is an excellent grafting material for nasal reconstruction. It has been used for augmentation of the nasal dorsum, tip grafting, and correction of vestibular atresia. The graft is harvested utilizing a technique that allows for minimal postoperative auricular deformity at the donor site. Aesthetic results have been satisfactory, with very low morbidity following this method.

scholarly journals Local flap for reconstruction of nasal defect following excision of basal cell carcinoma of nose

2016 ◽  
Vol 9 (4) ◽  
pp. 208
Author(s):  
Hasib Rahman ◽  
Syed Farhan Ali Razib ◽  
Md. Abul Kalam Azad ◽  
M. A. Mannan ◽  
Md. Ashik Anwar Bahar ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Local Flap ◽  
Nasal Reconstruction ◽  
Nasolabial Flap ◽  
Forehead Flap ◽  
Nasal Defect ◽  
Satisfactory Outcome

<p class="Abstract">Reconstruction of soft tissue at the nose following excision of basal cell carcinoma is always challenging, because of both functional and aesthetic importance of nose. The local flap is always preferable to skin graft as this produces “like with like” replacement, pliable cover and vascularized tissue over the skeletal framework. In this paper, we discussed six cases of nasal reconstruction with bilobed flap, forehead flap, and nasolabial flap. All flaps survived and the patients had satisfactory outcome.</p>

Extended Nasolabial Flap for Reconstruction of a Complex Nasal Tip and Columella Defect in an Elderly Polymorbid Patient

2018 ◽  
Vol 28 (1) ◽  
pp. 24-27
Author(s):  
Enrique - SALMERÓN-GONZÁLEZ ◽  
Elena - GARCÍA-VILARIÑO ◽  
Eduardo - SIMÓN-SANZ
Keyword(s):  
Nasolabial Flap ◽  
Nasal Tip

scholarly journals Reconstruction of the alae nasi by folded nasolabial flap

2007 ◽  
Vol 54 (2) ◽  
pp. 29-32 ◽  
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. .

scholarly journals Pediatric nasal reconstruction with frontal flap: a case report

2019 ◽  
Vol 7 (4) ◽  
pp. 1375
Author(s):  
Osvaldo Ivan Guevara Valmaña ◽  
Armando G. Apellaniz Campo ◽  
Daniel Angeles Gaspar ◽  
Leslie M. Leyva Sotelo ◽  
Enrique Chavez Serna ◽  
...  
Keyword(s):  
Case Report ◽  
Male Patient ◽  
Nasal Reconstruction ◽  
Nasal Deformity ◽  
Dog Bite ◽  
Nasal Tip ◽  
Partial Amputation ◽  
One Year

Authors presented the case of a 4-year-old male patient who suffered a dog bite on his face with partial amputation of the nasal tip, managed at another institution conservatively, so that one year after the injury he came for the nasal deformity. A frontal flap was performed for reconstruction achieving excellent results, coverage was achieved with similar characteristics of the skin as color and texture. The patient had a follow-up of 5 years with an appropriate course. Authors presented the case due to few reports in the literature of its use in children, where it can be observed that it is an excellent reconstructive tool.

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