A Unique Method for Total Nasal Defect Reconstruction - Prefabricated Innervated Osteocutaneous Radial Forearm Free Flap

Abstract

A 52-Year-old woman underwent a two-stage total nose reconstruction for complete nasal defect due to skin cancer. In the 1 st stage, innervated osteocutaneous radial forearm flap (“Neo nose”) was raised with the help of a 3D template. In the 2 nd stage, well vascularised “Neo-nose” was transferred to the face and covered with pre-expanded forehead flap.

A Novel Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) 3D Printing Method for Nasal Framework Reconstruction Using Microvascular Free Flaps

“…Recently, Walton et al described the use of a 3D scaffold to serve as a support and form modulator for nasal reconstruction [ 3 ], based on porous polyethylene, highlighting its advantages including excellent biocompatibility, tissue ingrowth, and adherence [ 10 , 11 ]. Additionally, a previous approach using a CAD/CAM method was described by Ahcan et al who used a prefabricated model to define the shape and contour of the flap [ 12 ]. In our case, we have incorporated a novel method for improving cartilage shaping using a CAD/CAM 3D printed model as a template for cartilage modeling.…”

Nasal Reconstruction by Expanded Forehead Scalping Flap: Case Report with Literature Review

“…There are many techniques with different indications, capabilities, and results for nasal reconstruction, such as composite auricular graft, forehead flap, scalping flap, washio flap and free flap. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] In children, nasal reconstruction with a forehead flap has been used with good advantages 11 but the skin graft scar or the vertical scar in expanded forehead cases, especially in darker skinned patients, is a problem. Converse 13 reported use of the scalping forehead flap for nasal reconstruction for the first time.…”

“…3 There are many techniques for nasal reconstruction, such as composite auricular graft, forehead flap, scalping flap, washio flap, and free flap. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] The double "S" principle is critical, where the first "S" refers to similarity of tissues, and the second "S" refers to the subunits-units principle for reconstruction. 6,7 Although the technique of reconstruction and similarity of tissues are very important, the donor site morbidity and scar should be considered as important items.…”

Single Stage Nasal Reconstruction in a Near Total Nasal Defect

“…For reconstruction of large full-thickness defects of the nose, placement of tissue expander, prefabrication of forehead flap, 5 and prefabricated radial artery-free flap 6 are alternative options, but they are not useful when immediate reconstruction is required like in wide local excision of squamous cell carcinoma of the nose. A combination of radial artery-free flap and forehead flap is the only option in such cases.…”