Prelaminated fascia lata free flap for large nasal septal defect reconstruction

Bank, Jonathan; Beederman, Maureen; Naclerio, Robert M.; Gottlieb, Lawrence J.

doi:10.1016/j.bjps.2014.05.027

Cited by 10 publications

(14 citation statements)

References 10 publications

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“…The options for closure of large symptomatic perforations are limited to repair of the defect. Several techniques for repairing septal perforations have been described, such as bilateral intranasal advancement or rotation flaps [5], unilateral middle turbinate mucosal flap [6], three-layer bridge [7], titanium membrane [8], prelaminated fascia lata free flap [9], polydioxanone plates [10], and high-density porous polyethylene [11]; yet these repair techniques still have high failure rates.…”

mentioning

confidence: 99%

Effect of Temporal Fascia and Pedicle Inferior Turbinate Mucosal Flap on Repair of Large Nasal Septal Perforation via Endoscopic Surgery

He²,

Bai³

2016

ORL

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Background: The repair of large nasal septal perforations (NSPs) is one of the most challenging procedures in nasal surgery. The aim of this prospective clinical study was to determine the efficacy of using a pedicle inferior turbinate mucosal flap combined with temporal fascia to repair a large NSP. Method: Between January 2008 and December 2015, 17 consecutive patients with large NSPs underwent septal perforation repair via an endoscopic approach using a pedicle inferior turbinate mucosal flap combined with temporal fascia. Results: Complete closure of the perforation was achieved in all patients. Conclusion: The pedicle inferior turbinate mucosal flap combined with the temporal fascia technique can easily solve this challenging problem, and the current data from this prospective study suggest that this technique shows promising results.

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mentioning

confidence: 99%

Effect of Temporal Fascia and Pedicle Inferior Turbinate Mucosal Flap on Repair of Large Nasal Septal Perforation via Endoscopic Surgery

He²,

Bai³

2016

ORL

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“…The advent of free tissue transfer significantly expanded the available reconstructive modalities in the head and neck. Regarding nasoseptal reconstruction in particular, the free radial forearm flap 11 and the fascia lata free flap 12 have been reported in the literature with favorable results.…”

Section: Discussionmentioning

confidence: 99%

“…In comparison to the often-bulky radial forearm flap, the TPF flap is significantly thinner and thus obviates the potential need for debulking. Although the benefits of prelamination in fascial flaps have been described, 12 the dependable vascularity of the TPF flap facilitates remucosalization by secondary intention, typically within 3 weeks. Ultimately, this precludes a prelamination procedure.…”

Section: Discussionmentioning

confidence: 99%

Temporoparietal Fascia Free Flap for a Large Nasal Septal Perforation

Cuccolo

Cauley

Sieber

et al. 2019

J Reconstr Microsurg Open

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Reconstruction of large nasal septal perforations can be a considerable challenge for surgeons. Reconstructive modalities are often determined by the size of the defect and the quality of local tissue and vasculature. Local and regional flaps may not provide enough tissue to achieve successful closure in patients with large perforations and those with baseline compromise of the nasal mucosa and blood supply from prior intervention or underlying medical condition. Microvascular free tissue transfer is a possible approach to reconstruction in these patients. We report a case of a 30-year-old man who presented with a large, symptomatic, 4 × 3.5 cm perforation as a result of prior functional septoplasty at an outside hospital. Reconstruction of the defect was accomplished in this setting with a free temporoparietal fascia (TPF) flap anastomosed to the columellar branch of the labial artery and the angular vein. Postoperative follow-up visits showed successful closure of the perforation without complications. As illustrated by this case, TPF flap is a versatile tool for complex nasal reconstructions. With minimal donor-site morbidity and rich vascularity capable of promoting remucosalization without the need for prelamination, the TPF flap may be suited for the repair of large nasoseptal perforations.

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“…Free flaps, including radial forearm free flap and fascia lata, are well suited for this task and are particularly useful in defects too large for regional flaps. 3,10 The free flap requires adequate exposure for the treatment of larger perforations. External septorhinoplasty, lateral alotomy, and historically even midface degloving have all been described for exposure of large septal perforations.…”

Section: Discussionmentioning

confidence: 99%

Temporoparietal Fascia Free Flap for Nasoseptal Perforation Repair

Helman

Kadakia

Guthrie

et al. 2018

Craniomaxillofacial Trauma & Reconstruction

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Nasoseptal perforations can be a challenging defect for the reconstructive surgeon, with repair limited by the surrounding tissue availability and the defect size. In patients with a history of cocaine use, often the integrity of surrounding vasculature is questionable and large defects may not be well suited for local reconstruction. In the otolaryngology literature, several reconstructive options using local tissue and synthetic materials have been described, but there have been no reports of microvascular free flaps utilized in this regard. We present a unique case of a 37-year-old woman with a 3.0 cm × 3.5 cm nasoseptal perforation secondary to cocaine use successfully reconstructed with a temporoparietal fascia free flap anastomosed to the facial artery and vein. Postoperatively, the patient had a well-healed septal defect from the free flap reconstruction This new technique shows promise as a feasible option for patients with large defects and for those with limited local reconstructive options. The ease of harvest and low donor-site morbidity make the temporoparietal fascia flap a suitable option for repair of complex nasoseptal defects.

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Prelaminated fascia lata free flap for large nasal septal defect reconstruction

Cited by 10 publications

References 10 publications

Effect of Temporal Fascia and Pedicle Inferior Turbinate Mucosal Flap on Repair of Large Nasal Septal Perforation via Endoscopic Surgery

Effect of Temporal Fascia and Pedicle Inferior Turbinate Mucosal Flap on Repair of Large Nasal Septal Perforation via Endoscopic Surgery

Temporoparietal Fascia Free Flap for a Large Nasal Septal Perforation

Temporoparietal Fascia Free Flap for Nasoseptal Perforation Repair

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