Bilateral Nasal Ala Reconstruction of the Cocaine-Injured Nose with 2 Free Reverse-Flow Helical Rim Flaps

Castelló, José R.; Scafati, Salvatore Taglialatela; Sánchez, Olaya

doi:10.1097/sap.0b013e3182750c4f

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…The shortness of the vascular pedicle is an inherent pitfall of free helical flap use. To overcome this, a reverse-flow design, an additional incision for obtaining a longer recipient vessel, and vascular grafts have previously been used [ 1 , 8 ]. However, in the present case, we performed the reconstruction using the branch and perforator, rather than the main trunk, at both the donor and recipient sites.…”

Section: Discussionmentioning

confidence: 99%

“…The introduction of the subunit principle changed the manner in which surgeons manage nasal defects [ 1 ]. The reconstruction of nasal defects in areas such as the alae and columella remains challenging due to the complex 3-dimensional nature of these structures.…”

Section: Introductionmentioning

confidence: 99%

“…However, pedicle shortage remains a major problem with free Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique auricular composite tissue transfer [3]. Several surgeons have attempted to overcome this limitation [1]. In this report, we describe the use of a new helical rim free flap technique for the reconstruction of full-thickness nasal alar defects via supermicrosurgery.…”

Section: Introductionmentioning

confidence: 99%

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Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique

Jeong

Choi

Hong³

et al. 2018

Arch Plast Surg

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The highly contoured nature of the nose and the abundant free margin makes it especially difficult to reconstruct. In this report, we describe the use of a new helical rim free flap technique for the reconstruction of full-thickness nasal alar defects via supermicrosurgery. Briefly, after a wide excision with a margin of 0.7 cm, an alar defect with a size of 1×1×0.5cm was obtained, which included the full thickness of the skin, mucosa, and lower lateral cartilage. Vessel dissection was performed in a straightforward manner, starting from the incision margin for flap harvest, without any further dissection for reach the greater trunk of the superficial temporal artery. The flap was inset in order to match the contour of the contralateral ala. We closed the donor site via rotation and advancement. No donor site morbidity was observed, despite the presence of a small scar that could easily be covered with hair. The alar contour was satisfactory, and the patient was satisfied with the results. The supermicrosurgical technique did not require further dissection to identify the vessels for anastomosis, leading to better cosmetic outcomes and a reduced operating time.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique

Jeong

Choi

Hong³

et al. 2018

Arch Plast Surg

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“…The majority of helical free flaps subsequently described in the literature are centered on the ascending helical rim, based on the superficial temporal vessels. Because the pedicle is short and thin, surgeons have attempted to overcome this limitation by using retrograde flow designs, additional proximal dissection of the pedicle, or utilizing supermicrosurgery [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Chondrocutaneous posterior auricular artery perforator free flap for single-stage reconstruction of the nasal tip: a case report

Lee

Seo

Jung

et al. 2021

Arch Craniofac Surg

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Full-thickness nasal tip reconstruction is a challenging process that requires provision of ample skin and soft tissue, and intricate cartilage structure that maintains its architecture in the long term. In this report, we describe reconstruction of a full-thickness nasal tip and ala defect using a posterior auricular artery perforator based chondrocutaneous free flap. The flap consisted of two lay ers of skin covering conchal cartilage, and was based on a perforating branch of the posterior auricular artery. A superficial vein was secured at the posterior margin. The donor perforator was anastomosed to a perforating branch of the lateral nasal artery. The superficial vein was connected to a superficial vein of the surrounding soft tissue. The donor healed well after primary closure. The flap survived without complications, and the contour of the nasal rim was sustained at follow-up 6 months later. As opposed to combined composite reconstructions using a free cartilage graft together with a small free flap or pedicled nasolabial flap, the posterior auricular artery perforator free flap encompasses all required tissue types, and is similar in contour to the alar area. This flap is a useful option in single-stage reconstruction of nasal composite defects.

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“…The reconstruction of the full-thickness defects involving the alar cartilage and mucosa may present difficulties because of the complex 3-dimensional structure of the alar region. 1 After reconstructions performed using inappropriate methods, functional problems including the collapse of the external nasal valve and esthetic problems such as retraction in the alar wing or asymmetry may develop. Therefore, reestablishing the 3-dimensional structure of the nasal ala is of utmost importance in the reconstruction to be performed.…”

Section: Introductionmentioning

confidence: 99%

Enhancement of Contour Using Laser Scar Treatment in the One-Stage Nasal Ala Reconstruction with Nasolabial Fold Flap

Lee

Park

2018

Medical Lasers

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Postoperative scarring around the nasolabial area and alar rim poses very high cosmetic concerns, leading to patient dissatisfaction. Several strategies, like laser therapy, have been developed to improve its clinical aspects. However, to date, little is known about when in the early wound healing phases laser exposure would have the most optimal results. This paper introduces a remarkable case of effectively treating a 32-year-old male patient with scarring on the alar rim and nasolabial fold using early active laser treatment. We started carbon dioxide (CO 2 ) laser therapy early in the second month after surgery. In the course of laser treatment, we performed a combined treatment using an ablative fractional CO 2 laser device and the combination of pulsed-dye laser and neodymium: yttrium-aluminum-garnet laser. A total of 7 sessions of CO 2 laser therapy and 3 sessions of cynergy laser therapy were performed, and the patient was followed-up for evaluation. These early laser treatments resulted in both patient and clinical satisfaction. In this case, we confirmed that early treatment with CO 2 laser and cynergy laser can have a positive effect on scarring of the alar rim and nasolabial fold. Key words

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Bilateral Nasal Ala Reconstruction of the Cocaine-Injured Nose with 2 Free Reverse-Flow Helical Rim Flaps

Abstract: Cocaine abuse can lead to nasal deformity because of local ischemia and subsequent fibrosis. Reconstruction can be challenging. We present a case of bilateral microsurgical nasal ala reconstruction with 2 reverse-flow helical rim flap.

Cited by 7 publications

References 11 publications

Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique

Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique

Chondrocutaneous posterior auricular artery perforator free flap for single-stage reconstruction of the nasal tip: a case report

Enhancement of Contour Using Laser Scar Treatment in the One-Stage Nasal Ala Reconstruction with Nasolabial Fold Flap

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