The Sandwich Supratrochlear Artery Perforator Flap with the Pericranium for Reconstruction of Full-Thickness Nasal Defects

Abstract

Introduction: Repair of the nasal defects is one of the most challenging areas for the reconstructive surgeons due to the lack of uniform skin thickness, complex contours, and small close subunits. Our aim is to utilize the bipaddle forehead flap with a cartilage graft in between for simultaneous cutaneous and lining reconstruction of the hemi-nasal defect after excision of the basal cell carcinoma. Patients and Methods: Our study included 25 patients with full thickness hemi-nasal defects after excision of basal cell carcinoma. We utilized the sandwich forehead flap which is bipaddle (cutaneous and periosteal layers) based on the deep and superficial perforator branches of the supratrochlear artery respectively, and cartilage graft in between. Results: Age of the patients ranged from 40 to 65 years (mean age of 51 years). With a follow-up period ranged from 6 to 18 months (mean of 11 months), no flap necrosis nor cartilage exposure were observed. Twelve cases only came back for debulking. Conclusion: The bipaddle forehead flap with intervening cartilage graft offers a good option for reconstruction of full thickness hemi-nasal defect with no extradonor site morbidity.