Effectiveness of Nasolabial Flap Versus Paramedian Forehead Flap for Nasal Reconstruction: A Systematic Review and Meta-analysis

Chakraborty, Sourabh Shankar; Goel, Akhil Dhanesh; Sahu, Ranjit Kumar; Midya, Manojit; Acharya, Sudeshna; Shakrawal, Neha

doi:10.1007/s00266-022-03060-w

Cited by 5 publications

(2 citation statements)

References 37 publications

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“…As with any procedure, the paramedian forehead flap poses a variety of post-surgical risks. Minor complications include infection, partial nasal collapse, incomplete nasal obstruction, epidermolysis, and alar asymmetry [6,21,[26][27][28]. Major complications include flap necrosis (both full and partial), nasal obstruction, alar notching, and asymmetry.…”

Section: Discussionmentioning

confidence: 99%

Danger Zone for Paramedian Forehead Flap Elevation: Maximizing Flap Length and Viability

Limback,

Kendell,

Motzko

et al. 2024

Surgeries

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The supratrochlear artery (STA) demonstrates anatomical variability that impacts facial reconstruction with a paramedian forehead flap. STA branching patterns and the distance to the midline have been reported, but the STA pedicle has not been characterized. Our aim was to triangulate the STA pedicle relative to known anatomical landmarks and identify a danger zone to aid surgeons in creating viable tissue flaps. The upper facial region was dissected bilaterally on 38 cadaveric donors. Measurements from the supraorbital neurovascular bundle, orbital rim, and medial canthus to the STA pedicle were collected. Data were tallied and statistically analyzed. Measurement means, range, and standard deviations were calculated; no significant differences were found in the laterality of the measurements (p > 0.05). Statistically significant, sex-based differences were identified for all measurements collected among male and female donors. This study characterizes a surgical danger zone for the STA pedicle specific to a paramedian forehead flap and identifies important differences within this danger zone among male versus female donors that surgeons should consider to prevent pedicle violation and enhance surgical success while maximizing flap length and mobility.

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Section: Discussionmentioning

confidence: 99%

Danger Zone for Paramedian Forehead Flap Elevation: Maximizing Flap Length and Viability

Limback,

Kendell,

Motzko

et al. 2024

Surgeries

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“…A systematic review and meta-analysis of 38 studies including 2,036 patients compared these techniques, finding that complication rates were similar in both groups with a marginal increase in the risk of alar notching with forehead flaps. 71 Despite satisfactory aesthetic results, interpolated flaps do carry concerns for the quality of life between staged divisions. Retrospective evidence finds that the drop in quality of life improves significantly at 16 weeks postflap takedown with no lasting, long-term impact (p < 0.001).…”

Section: Reconstruction Techniquesmentioning

confidence: 99%

State of the Evidence for Facial Skin Cancer Reconstruction

et al. 2023

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This review provides a comprehensive presentation of the evidence available in facial reconstruction post-Mohs Micrographic Surgery. Given the large diversity in post-Mohs reconstruction, there are limited guidelines in the management of defects. The aim of the present work is to provide a review of the best evidence as it pertains to several considerations in facial reconstruction. Data suggests that Mohs Micrographic Surgery and many reconstructive procedures can be performed as outpatient procedures under local anesthesia, with narcotic pain medication only given in certain patient populations following a minority of reconstructive procedures. Perioperative and topical antibiotics are generally not indicated. Aspirin and Warfarin can generally be continued for most reconstructive procedures, but clopidogrel and novel anticoagulants may predispose to increased bleeding complications. Delayed reconstruction appears to be safe, although data is discordant on this topic. No specific wound closure technique or suture choice appears to be consistently superior. Given the lack of robust comparative studies, consistent methodology, and variable defect sizes/ locations, no robust evidence-based guidelines can be generated for reconstruction techniques of facial subsites.

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The Comparison Competence Nasolabial and Forehead Flap for Reparation Nasal Tissue Defect of Basal Cell Carcinoma

Rashnoo,

Yegane,

Hassanpour

2024

J. Maxillofac. Oral Surg.

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Effectiveness of Nasolabial Flap Versus Paramedian Forehead Flap for Nasal Reconstruction: A Systematic Review and Meta-analysis

Cited by 5 publications

References 37 publications

Danger Zone for Paramedian Forehead Flap Elevation: Maximizing Flap Length and Viability

Danger Zone for Paramedian Forehead Flap Elevation: Maximizing Flap Length and Viability

State of the Evidence for Facial Skin Cancer Reconstruction

The Comparison Competence Nasolabial and Forehead Flap for Reparation Nasal Tissue Defect of Basal Cell Carcinoma

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