Reconstruction de pleine épaisseur de la pyramide nasale

Total nasal reconstruction in irradiated tissue, a new hope

“…It often entails multiple surgical procedures, and requires a threelayer-reconstruction i.e., inner lining, nasal framework, and outer skin. It is generally achieved using free flaps, costal or iliac bone grafts, covered with local flaps e.g., forehead flap 16,17 . All these procedures carry a significant donor site morbidity and risk of failure.…”

Nasal alar and lobule reconstruction – Case presentation

“…The flap design should be drawn after the cartilaginous support has been restored and the real soft tissue defect is correctly reassessed. If the flap has to be folded, an extra 2 mm of length is necessary 2 and its extremity can be thinned as needed 1 . The donor site can usually be closed directly, but larger flaps can impose the use of skin grafts or leaving a small area for secondary healing 9 .…”

“…Choosing the appropriate source of cartilage depends on the availability of soft tissues in the recipient area and the planned skin coverage method 2,4 . Alar cartilage can be replaced either with free grafts or pedicled chondromucosal flaps from the septum.…”

“…If the rotation creates a dorsal cartilaginous excess, it can be trimmed and used as a free graft if needed 1,9 . Nasal lobule defects should be reconstructed as a single esthetic unit, even if that means excising some normal skin 1,2,6,9 . The size of the defect precludes the use of local flaps, and the most used is the frontal flap 6,7,9 .…”

“…Cosmetic reconstruction of the tip of the nose poses problems because the surgeon must respect and restore all three layers of the region -outer skin, cartilaginous support and vestibular mucosal lining [1][2][3] . Choosing the appropriate source of cartilage depends on the availability of soft tissues in the recipient area and the planned skin coverage method 2,4 .…”