Microvascular Repair of Heminasal, Subtotal, and Total Nasal Defects with a Folded Radial Forearm Flap and a Full-Thickness Forehead Flap

Menick, Frederick J.; Salibian, Arthur H.

doi:10.1097/prs.0b013e3181fed686

Cited by 75 publications

(56 citation statements)

References 10 publications

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“…In the meantime, the maxillary or mandibular defects could be reconstructed with osteocutaneous flap 13Y15 for framework reconstruction. For the nasal lining defects, the free radial forearm flap could be used for temporary coverage and secondary hingeover lining flap 16 ; the free radial forearm flap covered with skin graft could be also used for lips lining reconstruction. In the second stage, a prefabricated cervicothoracic flap resurfaces the extensive face to acquire uniform and desirable facial appearance.…”

Section: Discussionmentioning

confidence: 99%

Flap Prefabrication and Stem Cell–Assisted Tissue Expansion

Zan

et al. 2014

Journal of Craniofacial Surgery

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Total face skin and soft-tissue defects remain one of the biggest challenges in reconstructive surgery. Reconstruction of the entire face with uniform coverage and delicate features is difficult to achieve. To avoid the patchwork result seen in multiple flaps and skin grafts, 1 monoblock flap that has similar color, texture, and thickness might be an ideal option to minimize the incisional scars and several surgical procedures but is unavailable with current approaches because of the lack of sufficient matched tissue and the unreliable blood supply for such a large flap. To acquire a monoblock flap for full face reconstruction, we combine the prefabricated flaps, skin overexpansion, and bone marrow mononuclear stem cell transplantation for total facial resurfacing. In this article, we present our experience from our case series that provides universally matched skin and near-normal facial contour. It is a reliable and an excellent reconstructive option for massive facial skin defect.

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Section: Discussionmentioning

confidence: 99%

Flap Prefabrication and Stem Cell–Assisted Tissue Expansion

Zan

et al. 2014

Journal of Craniofacial Surgery

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“…[22][23][24] The thinness, size, and long vascular pedicle make a radial forearm flap useful for complicated defects, especially in those who require both midvault and floor lining. 15,[25][26][27] If the normal external nasal skin remains, a radial flap can restore vault and floor lining circumferentially. If external nasal skin is missing, a radial flap can be folded…”

Section: External Skin Destructionmentioning

confidence: 99%

Primary Intranasal Lining Injury Cause, Deformities, and Treatment Plan

Menick

Salibian

2014

Plastic and Reconstructive Surgery

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Repair is determined by site, depth of injury, and clinical deformity--not cause. Lining necrosis and subsequent scar contraction, rather than structural compromise of the septum, are the primary causes of the severe deformity. If vault and floor lining injury is minimal, central support alone will restore dorsal and tip projection. Extensive loss requires release of scar contracture and replacement of the vault and floor lining with composite grafts, a microvascular flap, or hinge-over lining flaps, depending on the site and extent of injury. If the external skin is destroyed by scar or a full-thickness loss, a staged forehead flap will be required to resurface the nose.

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“…The lining tissue also needs to accommodate multiple grafts necessary to rebuild the nose. For many years, cutaneous free flaps have been used for reconstruction [14-16]. However, these flaps have the inherent disadvantages of creating a nose lined with thick keratinized squamous epithelium, donor site morbidity, and the inherent disadvantage of requiring multiple stages.…”

Section: Liningmentioning

confidence: 99%

Reconstruction of nasal defects: contemporary approaches

Austin

Shockley

2016

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review There are many well-established principles and surgical techniques for nasal reconstruction. The purpose of this paper is to describe contemporary reconstruction of nasal defects. The unique anatomic features of the nose make this a challenging task. While obtaining an optimal aesthetic result is always the goal of reconstruction, maintenance and restoration of nasal function are of equal importance. Recent findings The first step of nasal reconstruction is a thoughtful analysis of the defect. The best surgical option will provide the patient with an excellent aesthetic result and nasal function. Depending upon the extent of the defect as well as the anatomic site, a local flap, full-thickness skin graft, composite graft, or interpolated flap will provide the optimal result. The decision will depend on surgeon's experience and expertise, as well as expectations and desires of the patient. Many cutaneous defects will require not only reconstruction of the defect, but also cartilage grafts to provide nasal contour and support. Most large or complex defects will require a paramedian forehead flap for reconstruction along with cartilaginous and/or bony support, as well as a lining flap. Summary This article will highlight recent advances in nasal reconstruction and novel modifications of well-accepted traditional techniques.

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Microvascular Repair of Heminasal, Subtotal, and Total Nasal Defects with a Folded Radial Forearm Flap and a Full-Thickness Forehead Flap

Abstract: The approach is reliable, efficient, and applicable to varied defects and has the ability to correct design errors and complications before pedicle division. An unscarred lining sleeve, defined three-dimensional contour, and thin conforming skin cover are restored.

Cited by 75 publications

References 10 publications

Flap Prefabrication and Stem Cell–Assisted Tissue Expansion

Flap Prefabrication and Stem Cell–Assisted Tissue Expansion

Primary Intranasal Lining Injury Cause, Deformities, and Treatment Plan

Reconstruction of nasal defects: contemporary approaches

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