Tunneled Transposition Flap for Reconstruction of Defects of the Nasal Ala

Abstract

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Tunneled Melolabial Pedicle Flap for Small but Deep Lateral Alar Rim Defect

“…Tunneled flaps are a good way to recruit distant skin in surgical reconstruction and in this case provided an excellent result in restoring a small but deep defect of the lateral alar rim. Although tunneled flaps are prone to a pincushion effect, this was advantageous in this case because it helped to re‐create the rounded shape of the lateral ala.…”

A Tunneled and Turned-Over Nasolabial Flap for Reconstruction of Full Thickness Nasal Ala Defects

“…Krishnan and colleagues have described tunneling of a nasolabial flap to repair defects on the ala nasi but not full‐thickness defects of the alar rim as described here 6 …”

The Reverse Nasolabial Flap with a Cartilage Graft for the Repair of a Full-Thickness Alar Defect: A Single-Stage Procedure

“…Some single-stage procedures for repairing ala-perialar defects include the use of shark island pedicle flap9, nasolabial flap10, tunneled transposition flap7,11, composite cartilage and skin graft, and combinations of these techniques. Tunneled transposition flap and the auricular composite graft are strictly indicated for defects located entirely on the ala. Shark island pedicle flap resembles a shark with a snout and ventral mouth, and was developed for a combined ala-perialar defect with an intact alar rim.…”

“…The cartilage graft, consisting of cartilage with overlying perichondrium and harvested from the ear, was gently scored and sewn into place, bent outward to avoid alar collapse and to recover the alar contour12. This flap has many advantages4,5,6,7,11,12. First, it does not need several staged operations for replacing the inner nasal mucosa, structural support, and outer skin coverage.…”

“…Although there are many options for repairing deep alar defects, including two-stage interpolated cheek flap and paramedian forehead flap, none of them are ideal3,4,5,6,7,8,9,10,11. Lateral alar wounds of full thickness usually cause various problems in nasal function and aesthetic balance, and often require multistep repair techniques such as inner lining replacement, cartilage batten graft support, and outer skin coverage.…”