Flap reconstruction of soft tissue defect after resecting a huge hemangioma of the nose

Background: Correction of secondary cleft nose deformity is one of the most important portions in the management of cleft lip patients. Various techniques have been introduced to achieve adequate shape, balance, and symmetry of anatomical landmarks. None of these methods can claim to universally solve all aspects of the problems encountered in secondary cleft deformity surgery. Some authors overlook the aspect of functional rehabilitation with regard to nasal respiratory pathway problems, which is present in over 90% of the patients. This study aimed to evaluate the aesthetic and functional improvements of the authors’ non-destructive technique.Methods: With over 15 years of experience, open rhinoplasty was performed, which included total remodeling of the deformed lower lateral cartilage using several suture fixation techniques without any graft or implantation with septo-turbinoplasty. A total of 150 questionnaires were sent by e-mail, but 55 completed questionnaires were returned. Surgical outcomes were evaluated using questionnaire responses, and outcomes were divided into five categories each for esthetic and functional analyses.Results: The satisfaction rate ranged from 75 % to 98%, which means “more or less,” “very much,” and “absolutely yes” in the esthetic and functional viewpoints.Conclusion: The results of this study strongly recommend performing the suture fixation technique and functional rehabilitation simultaneously for cleft lip/nose correction.

Section: Discussionmentioning

confidence: 99%

Open rhinoplasty in secondary cleft nose deformity with suture techniques

Lee

Min

2022

“…4, 5). The flap size was designed to be 10% larger than the defect size rather than accu- If local flaps and grafts are insufficient, a forehead flap can be an excellent option for nasal reconstruction due to the reliability of the pedicle and the similarity of the skin [22,23]. When reconstructing large defects or reinforcing skeletal structures such as cartilage, a distant flap (e.g., a forehead flap) was used to avoid the risk of deformation of the perinasal structures (e.g., the inner canthus and nasal alae) (Figs.…”

Section: Discussionmentioning

confidence: 99%

A practical approach to nasal reconstruction in Asian patients

Koh

Sun

2021

Background: The study aimed to evaluate nasal reconstruction techniques customized for Asians. The currently available nasal reconstruction guidelines are based on Caucasian patients, and their applicability is limited in Asian patients due to differences in anatomical and structural features.Methods: A retrospective analysis was performed of the medical records of 76 patients who underwent nasal reconstruction at a single center between January 2010 and June 2020. A comprehensive evaluation was conducted of patients’ baseline demographics and clinical characteristics, including age, sex, medical history, defect size and location, reconstructive procedure, pathological diagnosis, postoperative complications, and recurrence.Results: In 59 cases (77%), nasal defects resulted from tumor ablation, and the remaining 17 cases involved post-traumatic (20%) and infection-induced (3%) tissue damage. The most common defect location was the alae, followed by the sidewalls, tip, and dorsum. Forehead flaps were the most commonly used reconstructive technique, followed by nasolabial advancement flaps, rotation flaps, and skin grafts. Each procedure was applied considering aspects of structural anatomy and healing physiology specific to Asians. Complications included nasal deformity, hypertrophic scarring, secondary infection, and partial flap necrosis, but no cases required additional surgical procedures. Tumors recurred in two cases, but tumor recurrence did not significantly affect flap integrity.Conclusion: Nasal reconstruction techniques applied considering Asians’ facial features resulted in fewer postoperative complications and higher patient satisfaction than the approaches that are currently in widespread use. Therefore, this study is expected to serve as an essential reference for establishing treatment guidelines for nasal reconstruction in Asians.

“…Reconstruction of alar defects is challenging due to the single-subunit structure of the ala and its limited mobility [ 6 ]. Causes of nasal defects include traumatic injury, viral infections, and tumor resection [ 7 ]. A wide range of reconstruction methods for alar defects can be chosen according to the size and depth of the defect, including primary repair, skin graft, composite auricular graft, cheek advancement, septal mucosal flap, and paramedian forehead flap.…”

Section: Discussionmentioning

confidence: 99%

One-stage reconstruction of full-thickness alar defects with a folded nasolabial island flap

Lee

Ryu

Choi

et al. 2021

Background: The reconstruction of large full-thickness alar defects requires complex surgical procedures that are usually performed in two stages, with concomitant disadvantages in terms of patient trauma, surgical risk, and cost. This study presents a functional folded nasolabial island flap (FNIF) that can be used to repair large-sized full-thickness alar defects in a straightforward manner.Methods: This retrospective study included seven patients who received a FNIF for a full-thickness alar defect between January 2007 and December 2020. The FNIF is different from the conventional nasolabial flap in that it is folded and twisted to achieve nostril reconstruction with a satisfactory three-dimensional mucosal lining in a single stage. The cosmetic and functional results of FNIF were evaluated by both patients and physicians.Results: The age ranged from 51 to 82 years (mean, 65.6 years). The causes of the defects were squamous cell carcinoma, basal cell carcinoma, and trigeminal trophic syndrome. The nostril lining did not collapse, there was no hypertrophic scarring, and air movement through the nostrils on the flap side was normal. Overall, FNIF produced excellent aesthetic and functional outcomes, with minimal patient discomfort. There were no postoperative complications.Conclusion: Compared with existing reconstruction methods for large full-thickness alar defects, FNIF can easily achieve aesthetic and functional success in a single-stage procedure. It provides satisfactory results for both the patient and the surgeon.