Nasalis Flap and Graft Repair Provides Reliable Closure for Denuded Defects of the Nose

Abstract

The SNAS flap and graft are simple to perform and provide a reliable alternative to interpolated nasolabial or forehead flaps when the defect exposes significant bare cartilage or bone.

Muscular Hinge Flaps

“…A cheek advancement flap and a full‐thickness skin graft were then used for coverage of the cheek and nasal subunit, respectively. Previously, we have reported our experience in the repair of deep, denuded defects of the nose using nasalis flaps before skin grafting as an alternative to two‐stage interpolated repairs 3 . Most recently, Braun and Cook reported on the application of hinge flaps for the repair of deep defects of the central face in an excellent article 4 …”

“…Fader and colleagues described their experience of reconstructing various nasal defects using a muscular hinge flap with overlying Burow's full‐thickness skin graft 5 . A similar technique, but allowing for much greater mobility of the nasalis musculature, was described with successful results in a series of 26 patients at our institution 3 . The transverse and anomalous nasalis muscle is dissected free of the overlying dermis and fatty tissue before division of the lateral and superior edges of the muscle to create a flap.…”

Reconstruction of the alae nasi by folded nasolabial flap

“…Pri rekonstrukciji potrebno je ulo'iti napor da bi se dobio normalan izgled. Hirurg mora pa'ljivo odabrati metod rekonstrukcije, imaju}i na umu boju ko'e, teksturu i nazalnu topografiju 3, 4,5,6,7,8 . Ko'a nosa varira u teksturi, boji i spolja{nosti u razli~itim zonama nosa.…”

“…Strane nosa su konkavne ali je povr{ina prema otvorima konveksna 4,5 . Susedne regije kao {to su: nos-obraz, nazolabijalna, alarna-usne, kolumelarna-usne imaju sopstvene karakteristike ~ije forme moraju biti o~uvane pri rekonstrukciji 5,6,7,8 .…”

“…Pre svake rekonstrukcije nosa potrebno je ustanoviti 5,6,7,8,9,10 . a) da li je defekt u zoni: 1. medijalnog kantusa, 2. zida nosa, 3. alarnog predela, 4. vrha nosa ili 5. kolumele.…”