Prefabricated Nasolabial Flap for Reconstruction of Full-Thickness Distal Nasal Defects

Abstract

BACKGROUND. The reconstruction of full-thickness nasal tip and alar defects is challenging owing to the distal nose's triple-layer structure: skin, cartilage, and mucosa. OBJECTIVE. In the reconstruction of wounds of the distal half of the nose involving the rim, the most important issue to be considered is to provide a good functional and an acceptable esthetic result. Various local and distant flaps have been described for this purpose. The nasolabial flap is one of the most frequently used flaps in reconstruction of small-to moderate-size distal nasal defects. Its reliable blood supply, minimal donor site morbidity, and excellent texture and color match are some of the advantages of this local flap.METHODS. In this study, superiorly based subcutaneous pedicled nasolabial flaps have been prefabricated with cartilage and skin grafts. This method has been used in 10 cases. RESULTS. One patient had partial flap necrosis, and two patients experienced hyperpigmentation on the suture line. Scar revision was performed in one patient for hypertrophic scar tissue at the flap margins. No other complications were seen in the remaining patients. None of the patients experienced a skin graft loss or cartilage exposure.CONCLUSION. The prefabricated nasolabial flap offers a superior esthetic and functional result and may be an appropriate reconstructive option in reconstruction of small-to moderate-size distal nasal defects.

Different Nasolabial flaps in nasal reconstruction

“…In our examination we experienced one patients experienced halfway fold putrefaction, one had fractional injury dehiscence and two had hypertrophic scar out of 30 cases. In an examination directed by Silistreli [10] one patient endured halfway nasolabial fold putrefaction and two had a hypertrophic scar in a sum of 10 cases. Anyway the investigation of Burgetand Hassan uncovered practically no entanglement with this fold [11].…”

A Prefabricated, Tissue-Engineered Integra Free Flap

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15] Some patients, however, may not have adequate normal skin to allow prefabrication of a flap. Prefabrication involves altering the blood supply of an area of native skin-specifically, transposing a vascular pedicle under the skin and subcutaneous tissue and waiting for the vascular sprouts from the pedicle to supply the overlying skin.…”

Reconstruction of the nose with a new double flap technique: microvascular osteocutaneous femur and microvascular chondrocutaneous ear flap—first clinical results

“…The best surgical technique is chosen according to the defect type, extending to nasal subunits 6-8 and neighbouring tissue defects as required. [8][9][10][11][12][13][14][15][16] The main techniques include local pedicled, or microvascular reanastomosed flaps, and free tissue grafts. 9 The major problem in surgical treatment lies in the complex anatomy of the nose.…”

“…Conventional local pedicled flaps from the frontal or cheek region sometimes need to be prelaminated by cartilage and/or mucosa transplantation before covering the defect. 14,15,17 Otherwise a transplantation of free grafts together with flap transposition is necessary to achieve stability in the reconstructed region. 9 In some patients with extended compound defects, microvascular reanastomosed flaps from a distant donor site are sometimes preferred.…”