Background: Coverage of post-traumatic or post-oncosurgical nasal defects is a very challenging procedure. Small nasal defects may be covered by skin grafts or small local flaps while larger nasal defects require more...Background: Coverage of post-traumatic or post-oncosurgical nasal defects is a very challenging procedure. Small nasal defects may be covered by skin grafts or small local flaps while larger nasal defects require more complex flap coverage techniques as using tissue expanders, prefabricated flaps or free flaps. The forehead flap has been used for centuries and remains a workhorse flap for reconstruction of large and complex nasal defects. Aim: evaluate the feasibility and versatility of forehead flap for resurfacing nasal defects. Materials and Methods: 12 patients underwent coverage of nasal defects after trauma or tumor excision using forehead flaps. All flaps needed a second stage for flap separation 3 weeks after the time of operation. The size of the harvested flap, the harvesting time, results of transferred flaps, patient satisfaction and flap-related complications were analyzed. Results: 12 patients (10 males and 2 females) underwent reconstruction of different nasal defects using 12 forehead flaps. The overall complications occurred in 2 patients. The remaining 10 patients showed no complications and passed an uneventful follow-up period. 7 Patients were very satisfied, 4 were satisfied and only one patient was not satisfied as she was 23 years old young female and was subjected to human bite. Follow-up periods ranged from 6 to 12 months. Conclusion: Nasal defects can successfully be managed with the forehead flap. Probably, the flap provides the best result due to the good matching of the skin in terms of color, texture, and thickness. Also, despite the increasing use of free flaps, the forehead flap is still a valid and safe option for nasal defects coverage that allows good aesthetics and functional outcomes.展开更多
Background: The repair of alar defects is challenging in clinics. Although skin grafts and nasolabial flaps are reliable, they can cause secondary post-surgical deformities.Methods: In this report, we describe an alar...Background: The repair of alar defects is challenging in clinics. Although skin grafts and nasolabial flaps are reliable, they can cause secondary post-surgical deformities.Methods: In this report, we describe an alar spiral advancement flap with a subcutaneous pedicle combined with postoperative nasal stent therapy for the repair of alar defects.Results: All cases showed slight asymmetry immediately after surgery, but at a median follow-up of 24 months, no cases of dissatisfaction with the nose shape or abnormal respiratory function were found. Almost all incision scars subsided within 12 months. In addition, all flaps that were dissected and rotated during the surgeries healed, and no signs of necrosis or development of vascular compromise were observed.Conclusion: Our preliminary experience suggests that the alar spiral flap followed by nasal stent therapy provides stable recovery of appearance and function for alar defects during follow-ups and shows promise for future therapies.展开更多
Local flaps are widely known as the best option for partial nasal reconstructions depending on donor tissue laxity,vascularization,and defect shape and size.The nasolabial flap is used more often in the nasal sill.For...Local flaps are widely known as the best option for partial nasal reconstructions depending on donor tissue laxity,vascularization,and defect shape and size.The nasolabial flap is used more often in the nasal sill.For larger defects,greater tissue mobilization with larger scars or free flaps is required.Historically,the Abbe flap has been used for lip reconstruction in patients with cleft lip deformities.It allows less retraction than other local flaps or skin grafts in patients with large defect sizes and great defect depths.This study reported on the application of the Abbe flap for nasal sill reconstruction on a 71-year-old female patient with nasal sill basal cell carcinoma who had undergone resection surgery with a posterior lip switch operation with satisfactory results.The application of the Abbe flap could be considered in patients with multiple previous surgeries and at risk for necrosis.展开更多
The defect after an enlarged resection of lower eyelid tumor was reconstructed by transplantation of a mucosaCartilage composite graft from the nasal septum and a mucosa graft from the oral cavity for inner part of th...The defect after an enlarged resection of lower eyelid tumor was reconstructed by transplantation of a mucosaCartilage composite graft from the nasal septum and a mucosa graft from the oral cavity for inner part of the eyelid. A pedicled skin flap from the adjacent region was rotated to cover the defect. The results in 4 patients were all satisfactory. The keypoint of the operation is the selection and design of an ideal pedicled skin flap.展开更多
文摘Background: Coverage of post-traumatic or post-oncosurgical nasal defects is a very challenging procedure. Small nasal defects may be covered by skin grafts or small local flaps while larger nasal defects require more complex flap coverage techniques as using tissue expanders, prefabricated flaps or free flaps. The forehead flap has been used for centuries and remains a workhorse flap for reconstruction of large and complex nasal defects. Aim: evaluate the feasibility and versatility of forehead flap for resurfacing nasal defects. Materials and Methods: 12 patients underwent coverage of nasal defects after trauma or tumor excision using forehead flaps. All flaps needed a second stage for flap separation 3 weeks after the time of operation. The size of the harvested flap, the harvesting time, results of transferred flaps, patient satisfaction and flap-related complications were analyzed. Results: 12 patients (10 males and 2 females) underwent reconstruction of different nasal defects using 12 forehead flaps. The overall complications occurred in 2 patients. The remaining 10 patients showed no complications and passed an uneventful follow-up period. 7 Patients were very satisfied, 4 were satisfied and only one patient was not satisfied as she was 23 years old young female and was subjected to human bite. Follow-up periods ranged from 6 to 12 months. Conclusion: Nasal defects can successfully be managed with the forehead flap. Probably, the flap provides the best result due to the good matching of the skin in terms of color, texture, and thickness. Also, despite the increasing use of free flaps, the forehead flap is still a valid and safe option for nasal defects coverage that allows good aesthetics and functional outcomes.
基金supported by the National Natural Science Foundation of China(grant nos.81701901 and 81801946)Natural Science Foundation of Shanghai Committee of Science and Technology(grant no.19ZR1430100)Shanghai Municipal Key Clinical Specialty(grant no.shslczdzk00901)。
文摘Background: The repair of alar defects is challenging in clinics. Although skin grafts and nasolabial flaps are reliable, they can cause secondary post-surgical deformities.Methods: In this report, we describe an alar spiral advancement flap with a subcutaneous pedicle combined with postoperative nasal stent therapy for the repair of alar defects.Results: All cases showed slight asymmetry immediately after surgery, but at a median follow-up of 24 months, no cases of dissatisfaction with the nose shape or abnormal respiratory function were found. Almost all incision scars subsided within 12 months. In addition, all flaps that were dissected and rotated during the surgeries healed, and no signs of necrosis or development of vascular compromise were observed.Conclusion: Our preliminary experience suggests that the alar spiral flap followed by nasal stent therapy provides stable recovery of appearance and function for alar defects during follow-ups and shows promise for future therapies.
文摘Local flaps are widely known as the best option for partial nasal reconstructions depending on donor tissue laxity,vascularization,and defect shape and size.The nasolabial flap is used more often in the nasal sill.For larger defects,greater tissue mobilization with larger scars or free flaps is required.Historically,the Abbe flap has been used for lip reconstruction in patients with cleft lip deformities.It allows less retraction than other local flaps or skin grafts in patients with large defect sizes and great defect depths.This study reported on the application of the Abbe flap for nasal sill reconstruction on a 71-year-old female patient with nasal sill basal cell carcinoma who had undergone resection surgery with a posterior lip switch operation with satisfactory results.The application of the Abbe flap could be considered in patients with multiple previous surgeries and at risk for necrosis.
文摘The defect after an enlarged resection of lower eyelid tumor was reconstructed by transplantation of a mucosaCartilage composite graft from the nasal septum and a mucosa graft from the oral cavity for inner part of the eyelid. A pedicled skin flap from the adjacent region was rotated to cover the defect. The results in 4 patients were all satisfactory. The keypoint of the operation is the selection and design of an ideal pedicled skin flap.
