Anterior Pedicled Lateral Nasal Wall Flap for Endonasal Lining: A Radiologic and Anatomical Study

Abstract

Objectives/Hypothesis The objective of this radiological/anatomical study was to evaluate the feasibility of a new endoscopic technique that uses the anterior pedicled lateral nasal flap (APLNW) for the endonasal lining in complex nasal reconstructions. Study Design An anatomical study was performed on 20 nasal fossae of cadaverous specimens to measure the area and lengths of the anterior pedicled nasal lateral wall flap. In addition, a radiological analysis with computed tomography was performed in 150 nostrils to determine the potential donor of the simple and extended flap in the nasal fossa floor. Complex nasal reconstruction with nasofrontal flap and internal lining using the lateral wall pedicled flap was performed in 3 patients. Results Complete reconstruction for the inner lining of the nasal tip and lateral nasal wall was achieved in the cadaveric study (10 specimens). The surface areas of the simple and extended APLNW flaps were 7.53 (standard deviation [SD] 1.25) cm2 and 24.6 (SD 3.14) cm2, respectively. Using computed tomography scans, we determined that to reconstruct defects secondary to full‐thickness nasal defects, the APLNW flap surface for the simple and extended versions was 7.90 (SD 1.68) cm2 and 23.64 (SD 4.7) cm2. We present one case were the APLNW flap was used. Conclusions The simple or expanded APLNW flap represents a feasible option to reconstruct the internal lining in complex nasal reconstruction. Level of Evidence NA Laryngoscope, 131:E1462–E1467, 2021

Nasal and Cheek Reconstruction with Flaps

“…There are different possibilities, but the unilateral lateral wall flap with or without extension to the nasal floor, with an anterior pedicle (anterior ethmoid and facial artery [2]) allows reconstruction of the mucosal lining, reaching the anterior sector of the nasal tip when it is rotated [3,4].…”

Mucosal Reconstruction with Nasal Lateral Wall Flap after Rhinectomy: Two Case Reports

“…Langdon, et al [7] conducted a study in 10 cadavers and reported that with the lateral wall flap they were able to reconstruct defects of approximately 4 cm long × 2.5 cm wide, and using the flap with extension to the nasal floor they repaired defects of 5 × 5 cm. They described a clinical case of reconstruction with this flap after a rhinectomy without skin resection.…”