Elongated Dorsal Nasal Flap to Reconstruct Large Defects of the Nose

Abstract

Elongated dorsal nasal flap is a reproducible one-stage flap for large defects of the nose, with minimal risk of aesthetic or functional complications.

Revisiting the Rintala advancement flap for nasal tip reconstruction

“…Alternatively, the Rieger flap has been demonstrated as a reliable reconstructive option in nasal tip and nasal dorsum defects that range from 1.0 to 1.5 centimeters [5]. This modified rotational flap utilizes the tissue reservoir of the superior nasal dorsum and/or nasal root as it recruits from tissue laxity in the horizontal and vertical vectors; the latter is due to the [5]. However, given this rotational component, the Rieger flap is limited by the pivotal restraint of the rotating base.…”

Reconstruction of dorsum of nose after excision of basal cell carcinoma

“…In 1967 Rieger popularized the surgical reconstruction using the dorsal nasal flap. 6 The dorsal or Rieger flap is considered basically a rotational flap of the nasal dorsal skin. 7 Originally designed as a random flap, and transformed into an axial flap, 2 cm diameter lesions were recommended.…”

“…7 Originally designed as a random flap, and transformed into an axial flap, 2 cm diameter lesions were recommended. 6 Some modifications to the procedure have been suggested since it was first described, thus improving its applicability. These concern the lateral design as well as the proximal portion next to the glabella.…”

Nasal dorsum reconstruction in the cutaneous oncology setting

“…Sometimes the rotation movement generates a secondary defect in the nasofacial groove area that is best closed using a cheek advancement procedure. After suture into position, dog ear created by rotation at the lateral side should be excised 20,21 .…”

“…For example, the leading edge of flap rotation can be lengthened to provide tissue from the adjacent nasal skin, the cheek, or the nasolabial groove to close the defect. This approach is particularly useful for large lateral defects 21 . Avoiding excessive tension closure is essential to prevent significant tip elevation and alar retraction or alar asymmetry.…”