Microvascular Reconstruction of Nasal Defects

Antunes, Marcelo B.; Chalian, Ara A.

doi:10.1016/j.fsc.2010.10.014

Cited by 20 publications

(44 citation statements)

References 29 publications

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“…A careful analysis of the defect must take into consideration what will be required for restoration of the different structural elements and subunits. Since extensive loss of tissues cannot be managed with only local flaps the final reconstruction can be generally obtained with multistaged procedures, often involving the need for microvascular free flaps (Antunes & Chalian, ; Kim, Boahene, Byrne, & Desai, ; Mathy & Pribaz, ).…”

Section: Discussionmentioning

confidence: 99%

Medial femoral condyle free flap in combination with paramedian forehead flap for total/subtotal nasal reconstruction: Level of evidence: IV (therapeutic studies)

et al. 2019

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Background The nose is a functionally complex organ with also a critical role in aesthetics. For reconstruction of full thickness nasal defects, multiple stages are needed and there is risk for resorption resulting in residual deformity. The aim of this report was to develop and evaluate a new method for full thickness total/subtotal nose reconstruction using the medial femoral condyle free flap (MFCFF) in combination with a paramedian forehead flap. Methods Between November 2015 and January 2018, eight patients (four males, four females) mean age 52 years (range 40–73 years) undergoing a total/subtotal nasal excision and subsequential reconstruction with MFCFF plus paramedian forehead flap were enrolled. Six cases were squamous cell carcinomas while two were basal cell carcinomas. The MFCFF was stabilized, with the periosteum as inner layer, with plates and a paramedian forehead flap was used as external skin coverage. All patients were evaluated for with postoperative nasal endoscopy and CT scan. A postoperative questionnaire was given 6 months after surgery. Results The mean MFCFF size was 2–3.8 cm × 2.25–2.5 cm with a mean pedicle length of 6.3 cm (range 4.1–9.4 cm). The postoperative period was uneventful. The mean follow‐up was 16 months, no bone displacement or resorption was observed at the CT scan, no evidence of nasal stenosis occurred. All patients had a satisfying aesthetic evaluation and a good subjective nasal function. Conclusions In this series, the MFCFF in combination with the paramedian forehead flap appeared to provide a valid subtotal nose reconstruction, allowing for the recreation of all the three nasal layers and maintaining the nose projection and airway patency in the long term.

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Section: Discussionmentioning

confidence: 99%

Medial femoral condyle free flap in combination with paramedian forehead flap for total/subtotal nasal reconstruction: Level of evidence: IV (therapeutic studies)

et al. 2019

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“…Different types of free flaps have been used for nasal resurfacing, each one with its own advantages and disadvantages (Antunes & Chalian, ; Benmeir et al, ; Iglesias et al, ; Prousskaia et al, ). These flaps were usually fasciocutaneous flap, thin in both the skin and the soft tissue, creating the contour around the nasal framework and providing adequate lining without obstructing the nasal airway (Antunes & Chalian, ). Second, they usually had a long pedicle to achieve recipient vessels (Antunes & Chalian, ).…”

Section: Discussionmentioning

confidence: 99%

“…The most important aspect of nasal microvascular reconstruction is the separate analysis of each component of the nasal defect: skin, osteocartilaginous framework, and lining (Antunes & Chalian, ). Options for nasal lining reconstruction include skin grafting, mucosal grafting, local flap, turn‐over flap, pedicled flap such as reversed facial artery musculomucosal flap, folded forehead flap, or free flap (Winslow et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…The ideal nasal contour comes from not only exquisite skin envelope but also the steady underling platform and framework, which was different from resurfacing the other facial units due to its three-dimensional structure. In this report, we focused and concentrated on the indication, flap choice and Different types of free flaps have been used for nasal resurfacing, each one with its own advantages and disadvantages (Antunes & Chalian, 2011;Benmeir et al, 1991;Iglesias et al, 2008;Prousskaia et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…These flaps were usually fasciocutaneous flap, thin in both the skin and the soft tissue, creating the contour around the nasal framework and providing adequate lining without obstructing the nasal airway (Antunes & Chalian, 2011). Second, they usually had a long pedicle to achieve recipient vessels (Antunes & Chalian, 2011).…”

Section: Discussionmentioning

confidence: 99%

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