The Spiral Flap for Nasal Alar Reconstruction: Our Experience with 63 Patients

Abstract

The spiral flap is a reproducible, one-stage flap for small to medium-sized defects of the nasal ala and alar groove that consistently produces topographic restoration with minimal risk of aesthetic or functional complication.

Logarithmic Spiral Flap for Circular or Oval Defects on the Lateral Surface of the Nose and Nasal Ala: A Series of 15 Cases

“…However, in contrast to those authors, we used the technique described by Mahlberg et al,7 in which the flap had a logarithmic design that produced a spiral with a diameter that progressively increased along the length of the flap rather than remaining constant. This increases the surface area of the flap and creates a larger vascular pedicle, reducing the risk of necrosis.…”

The conchal bowl donor site for full‐thickness skin graft reconstruction of nasal ala surgical defects: a comprehensive review, approach and outcomes of 81 cases over 10 years

“…Meticulous care is required to avoid distortion of the alar free margin, alar facial sulcus and alar crease. In the literature, several flap repairs have been utilized for alar defects, such as spiral flap or interpolated cheek or forehead flap …”

Post-Skin Cancer Alar Reconstruction

“…The spiral flap represents an excellent option for deep defects that span the alar groove and involve both the ala and nasal sidewall. [28][29][30] Traditionally, limited to defects of less than 8 to 10 mm, recent modifications may allow use in slightly larger wounds. 30 All modifications of the spiral flap share several key features.…”

“…[28][29][30] Traditionally, limited to defects of less than 8 to 10 mm, recent modifications may allow use in slightly larger wounds. 30 All modifications of the spiral flap share several key features. The spiral flap is a laterally based rotation flap that moves inferiorly to repair the sidewall portion of the defect before folding upon itself to repair the alar portion of the defect and recreate the alar groove.…”

“…The anterior extension should have a width equal to the height of the alar defect. 30 The flap broadens as it passes onto the nasal sidewall and crosses around the superior aspect of the wound. The anterior extension of the flap is folded inward to meet the body of the flap with the first suture.…”