Through-and-through Nasal Reconstruction with the Bi-Pedicled Forehead Flap.
10.5999/aps.2013.40.6.748
- Author:
Tommaso AGOSTINI
1
;
Raffaella PERELLO
;
Giulia Lo RUSSO
;
Giuseppe SPINELLI
Author Information
1. Department of Plastic and Reconstructive Surgery, University of Florence, Faculty of Medicine and Surgery, Florence, Italy. tommasoagostini@ymail.com
- Publication Type:Original Article
- Keywords:
Nose neoplasms;
Nose deformities, acquired;
Surgical flaps;
Nasal surgical procedures;
Nasal bone
- MeSH:
Cheek;
Forehead*;
Frozen Sections;
General Surgery;
Head;
Humans;
Microsurgery;
Nasal Bone;
Nasal Surgical Procedures;
Neck;
Nose Deformities, Acquired;
Nose Neoplasms;
Orbit;
Skin;
Surgical Flaps
- From:Archives of Plastic Surgery
2013;40(6):748-753
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Nasal reconstruction is one of the most difficult challenges for the head and neck surgeon, especially in the case of complex full thickness defects following malignant skin tumor resection. Full-thickness defects require demanding multi-step reconstruction. METHODS: Seven patients underwent surgical reconstruction of full-thickness nasal defects with a bi-pedicled forehead flap shaped appropriately to the defect. Patients were aged between 58 and 86 years, with a mean age of 63.4 years. All of the tumors were excised using traditional surgery, and in 4 of the patients, reconstruction was performed simultaneously following negativity of fresh frozen sections of the margins under general anesthesia. RESULTS: Nasal reconstruction was well accepted by all of the patients suffering non-melanoma skin tumors with acceptable cosmetic outcomes. The heart-shaped forehead flap was harvested in cases of subtotal involvement of the nasal pyramid, while smaller defects were reconstructed with a wing-shaped flap. No cartilaginous or osseous support was necessary. CONCLUSIONS: This bi-pedicled forehead flap was a valid, versatile, and easy-to-implement alternative to microsurgery or multi-step reconstruction. The flap is the best indication for full-thickness nasal defects but can also be indicated for other complex facial defects in the orbital (exenteratio orbitae), zygomatic, and cheek area, for which the availability of a flap equipped with two thick and hairless lobes can be a valuable resource.
