The caudolaterally inserted transposition flap and its variations for reconstruction of defects of the nasal ala

Abstract

SummaryClosure of non-full-thickness defects of the nasal ala can be a surgical challenge. While there is a plethora of various reconstructive techniques, not all of them are easy to learn and carry out. Recently, the dermatosurgeon Andreas Lösler from the Department of Dermatology at the Hornheide Medical Center, Germany, developed and published the caudolaterally inserted transposition flap for the reconstruction of alar defects. Given its relative novelty, this technique, which is characterized by a very low complication rate, is still unknown to most dermatosurgeons and has not yet found its way into standard dermatosurgery textbooks. The present review describes the caudolaterally inserted transposition flap and two modifications thereof, which allow for the closure of large alar defects as well as defects of the alar crease. Comparisons are made to the two flaps most commonly employed for alar reconstruction, the bilobed flap and the cranially inserted nasolabial transposition flap (melolabial flap).

Pengtala‐Lappen zur Rekonstruktion von Defekten an der Nasenspitze

“…Klassischerweise wurden bei der Rekonstruktion kleiner Defekte die primäre Deckung, die sekundäre Wiederherstellung, lokale Lappen und Vollhauttransplantate beschrieben. Bei mittelgroßen Defekten (1,5–2,5 cm) kamen unter anderem auch der paramediane Stirnlappen, der Rintala‐Lappen, der Peng‐Lappen, der doppelflügige Lappen (die Zitelli‐Variante), subkutane gestielte Lappen, myokutane Lappen und Transpositionslappen zum Einsatz .…”

Pengtala flap for reconstructing nasal tip defects

“…Classically, primary closure, secondary intention repair, local flaps and full‐thickness skin grafts have been reported in the reconstruction of small defects. In the case of medium‐sized defects (1.5–2.5 cm), the paramedian forehead flap, Rintala flap, Peng flap, bilobed flap (Zitelli variant), subcutaneous pedicled flaps, myocutaneous flaps and transposition flaps have also been used, among others .…”

Reconstruction of defects of the proximal nasal sidewall using the procerus perforator flap

“…The nose is a common site requiring surgical reconstruction following the removal of epithelial tumors. Consequently, there is a large number of options for repairing the various aesthetic units of the nose . However, nasal reconstruction using a perforator flap is rather unusual as it is somewhat more difficult to perform than flaps with a continuous epithelium due to the poorer blood supply and is more prone to flap hypertrophy.…”