Oncologic defects of head and neck often result in complex reconstructive problems. Achieving both aesthetic and functional restoration after tumor resection, 1-stage reconstruction is certainly the best option. However, seeking a reliable and suitable flap for 1-stage reconstruction remains a great challenge for plastic surgeons. 1 In 1963, Converse and Wood-Smith were the first to describe supratrochlear artery forehead island (STAFI) flap for 1-stage reconstruction of nasal dorsum defects. 2 Since then, STAFI flap has been widely utilized to repairing skin soft tissue defects caused by congenital malformation, trauma, and tumor resection. However, STAFI flap has certain drawbacks such as distorted eyebrows, limited reach, and requiring correction in a second stage. To address these issues, we modify a tunneled design for single-stage reconstruction of nasal defects. To distinguish the traditional STAFI flap, this modified supratrochlear artery forehead flap was named modified supratrochlear artery forehead island (MSTAFI) flap. Herein, we share our own clinical experience of using MSTAFI flap as an aid to repair a large nasal defect in a patient with squamous cell carcinoma.A 49-year-old man was referred to our department for surgical treatment of a squamous cell carcinoma on the nasal dorsum. Physical examination revealed a 2 Â 3 cm illdefined brown patch on a background of photodamaged skin (Figure 1). Surgical excision was performed, with a final defect consisting of an oval, vertically oriented, full-thickness skin defect measuring 4 Â 4 cm without involvement of the bilateral alar (Figure 2A). According to the preoperative design, an MSTAFI flap was successively performed. Final pathology studies disclosed squamous cell carcinoma of nasal dorsum. At 5-year follow-up visit after operation, the patient had achieved an excellent color match and a favorable aesthetic restoration without tumor recurrence (Figure 3).The surgical technique consists of the following. Once the defect is outlined, the supratrochlear artery is identified by means of a Doppler probe and marked on the skin. Full thickness of skin is incised around the inverted pattern of the defect outlining the skin portion of the island flap. A transverse leaf-shaped island flap is excised superficially from the median forehead area. The skin of the forehead is then undermined downward over the glabella and inner canthus as far as the

No abstract

An oncologic defect that includes both the lower eyelid and the infraorbital cheek often results in complex reconstructive problems because its reconstruction involves 2 distinct tissue types and cosmetic subunits. Herein, we first present a novel combination of modified supratrochlear artery forehead island flap and advancement rotation cheek flap enables reconstructing a large oncologic defect of lower eyelid and infraorbital cheek. Although discoid lupus erythematosus affects the skin, the patient had achieved a satisfying color match and an acceptable aesthetic restoration without tumor recurrence. This novel flap has shown to be feasible, reliable, and advantageous alternative to the repair of such defects.