Reconstruction of full-thickness nasal defect by free anterolateral thigh flap

Livaoğlu, Murat; Karaçal, Naci; Bektaş, Devrim; Bahadır, Osman

doi:10.1080/00016480802258810

Cited by 12 publications

(15 citation statements)

References 13 publications

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“…The primary search identified 305 unique articles, of which 257 were excluded after title and abstract review (Figure ). After 48 full‐text articles were reviewed by two independent reviewers (MR and GK), a total of 22 articles fulfilled the inclusion criteria (Acikel, Bayram, Eren, & Celikoz, ; Beahm, Walton, & Burget, ; Burget & Walton, ; Choi, Joo, Jeong, & Jang, ; Cinpolat, Bektas, & Coskunfirat, ; Fujioka, Hayashida, Murakami, & Koga, ; Gaggl, Burger, & Chiari, ; Hirase, Kojima, Takeishi, Hayashi, & Shinoda, ; Hsiao et al, ; Karadsheh, Turfe, & Komorowska‐Timek, ; Livaoglu, Karacal, Bektas, & Bahadir, ; Menick & Salibian, ; Moore, Montgomery, McMahon, & Sheikh, ; Moore, Strome, Kasperbauer, Sherris, & Manning, ; Nisanci, Turegun, Er, & Sengezer, ; Senda et al, ; Seth, Revenaugh, Scharpf, Shipchandler, & Fritz, ; Swartz, ; Upton, Ferraro, Healy, Khouri, & Merrell, ; Wehrens, Hawinkels, Fresow, Van der Hulst, & Boeckx, ; Winslow, Cook, Burke, & Wax, ; Zhou, He, Liao, & Yao, ). Study design consisted of 13 case reports and 9 case series (Table ).…”

Section: Resultsmentioning

confidence: 99%

Microvascular lining options for subtotal and total nasal reconstruction: A scoping review

et al. 2019

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Background: Restoration of nasal lining is essential in reconstruction of subtotal/total nasal defects. When local flaps are inadequate, a microvascular flap should be used. The purpose of this scoping review is to map the literature and identify the described flap options for subtotal/total nasal reconstruction. Further to that, we will summarize the stated advantages and disadvantages, evaluate functional and esthetic outcomes, and appraise the current body of literature. Methods: An electronic literature search was completed. Studies required adult patients with subtotal/total nasal defects and lining reconstruction with microvascular free flap. Two independent reviewers completed screening and data extraction. Flap characteristics, advantages, disadvantages, functional and esthetic outcomes were reviewed. Two independent reviewers evaluated study quality. Results: Of 305 initial articles, 22 studies were included (13 case reports, 9 case series) accounting for 65 flaps. Microvascular flaps varied by composition and anatomical location. For functional outcome, 13 studies used clinical exam by surgeon, 5 reported patient being satisfied, 3 studies used endoscopy, and 1 study used nasometry. Assessing esthetic outcome, 13 studies used clinical exam by surgeon, 5 studies reported patient being satisfied, 1 study used patientreported outcome measures, and 16 studies included photos. Study quality (modified CARE and PROCESS checklists) was deemed poor. Quality of available evidence was level IV.Conclusions: Microvascular free flaps for nasal reconstruction, confer an overall satisfactory functional and esthetic outcome. All studies lack a systematic and comprehensive approach to assessing and reporting these outcomes. Future research should provide objective assessment and utilize patient reported outcome measures.

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Section: Resultsmentioning

confidence: 99%

Microvascular lining options for subtotal and total nasal reconstruction: A scoping review

et al. 2019

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“…However, the conventional ALT flap is often too bulky for resurfacing face defects, so it often needs to be performed a secondary debulking procedure. Moreover, the disadvantages of the free ALT are that skin color and texture are not similar to facial skin, and there is a high incidence of hair presence, especially in male patients [10] , [11] , [12] , [13] .…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of a massive facial defect with the pre-expanded free anterolateral thigh flap: A case report

Sơn

Dung

Huy

2022

International Journal of Surgery Case Reports

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Introduction and importance Massive facial defects remain a reconstructive challenge because of the region's unique character and the limitation of a well-matched donor site. Pre-expanded free anterolateral thigh (ALT) flap provides a good alternative for reconstructing massive skin and soft tissue defects. Case presentation A 21-year-old male patient presented to our department with a massive right facial degloving wound caused by a sharp edged-weapon attack. The patient left the hospital after 3 weeks of wound care, and only came back to us after 2 months with large defects at the nasal, cheek, and upper and lower right lip regions. The procedure of ALT flap expansion surgery was performed for 2 months. The pre-expanded ALT flap was used for reconstruction of the patient's facial defects. Two-year follow-up showed that the flap at the reconstructed area resembled the contour of the nasal tip, facial skin color similarities in the cheeks and lips, and the patient's mouth had normal function. Clinical discussion The combined pre-expanded and composite ALT free flap techniques allow simultaneous reconstruction of many different anatomic units. Flap debulking helps to improve the nasal contour from the original defect. The lip separation technique and flap debulking procedure help enhance aesthetic reconstructive outcomes of the skin flap. Conclusion The surgical reconstruction using a pre-expanded ALT free flap for the patient with a massive facial defect was safe. In particular, sufficient skin and soft tissue ensured facial aesthetics and oral function for the patient when using this method.

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“…Two veins accompany the artery and then merge into one at profundal femoral vein junction. It could be used for full-thickness nasal defect reconstructions, mostly orbital walls or total maxillectomy defects, with good functional results ( 61 , 62 ). In postoperative imaging, it is easily differentiated from adjacent tissues, thanks to the hypodense central fatty component, which can reach 1 to 3cm.…”

Section: Type Of Reconstructions In Sinonasal Tumors Surgerymentioning

confidence: 99%

Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know

Carsuzaa

Vérillaud

Marcy³

et al. 2022

Front. Oncol.

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In sinonasal cancer surgery, a fundamental challenge is to understand the postoperative imaging changes after reconstruction. Misinterpretation of post-operative imaging may lead to a misdiagnosis of tumor recurrence. Because radiotherapy planning is based on imaging, there are many gaps in knowledge to be filled in the interpretation of postoperative imaging to properly define radiotherapy tumor volumes in the presence of flaps. On the other hand, radiotherapy may be responsible for tissue fibrosis or atrophy, the anatomy of the reconstructed region and the functional outcomes may change after radiotherapy compared to surgery alone. This narrative review illustrates the interdisciplinary aims and challenges of sinonasal reconstructive surgery using flaps or grafts. It is particularly relevant to radiologists and radiation oncologists, at a time when intensity modulated radiotherapy and proton therapy have the potential to further contribute to reduction of morbidity.

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Reconstruction of full-thickness nasal defect by free anterolateral thigh flap

Abstract: All flaps survived completely. The average hospitalization time was 3 days. No complication was observed.

Cited by 12 publications

References 13 publications

Microvascular lining options for subtotal and total nasal reconstruction: A scoping review

Microvascular lining options for subtotal and total nasal reconstruction: A scoping review

Reconstruction of a massive facial defect with the pre-expanded free anterolateral thigh flap: A case report

Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know

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