Evaluation of Modified Dorsonasal Flap for Reconstruction of Dorsonasal Defect in Erbil

Elza Faiz  Hanna; Sabir Osman  Mustafa

doi:10.56056/amj.2022.141

Authors

Elza Faiz Hanna M.B.Ch.B., KBMS trainee in plastic surgery, Erbil center
Sabir Osman Mustafa M.B.Ch.B., HDGS, FIBMS (plastic)., Assistant professor in Hawler medical university

DOI:

https://doi.org/10.56056/amj.2022.141

Keywords:

Nasal reconstruction, Flap, Basal cell carcinoma, Squamous cell carcinoma, Reiger’s flap

Abstract

Background and objectives: nasal reconstruction is challenging for plastic surgeons mainly because of its midfacial location and the relationship between convexities and concavities of nasal subunits that make it difficult to hide any contour deformity; as a result, proper planning of final scar location is crucial for a successful aesthetic outcome. The modified dorsal nasal flap is used for resurfacing nasal tip defects with respect to these nasal subunits. This paper evaluates the outcome of a modified dorsonasal flap for reconstruction of the dorsal nasal defects.

Method: in our department twenty nasal defects were reconstructed with modified dorsal nasal flap between years (2016-2019); Charts of these patients were analyzed in relation to their age, cause and size of the defect, complications and appearance.

Results: Half of the patients who underwent nasal reconstruction by dorsal nasal flap were males (n=10) and the other half were females (n=10), mean age was 39.5 months, median defect diameter was (21mm), and follow-up period ranged from (7-42 months), all patients were satisfied with results with no significant complications including hematoma, infection, flap loss or wound dehiscence. Conclusion: Dorsal nasal flap is a reproducible one-stage flap for reconstruction of nasal defects with minimal complication and good aesthetic outcome.

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References

- Kang KW, Lee DL, Shin HK, Jung GY, Lee JH, Jeon MS. A retrospective clinical view of basal cell carcinoma and squamous cell carcinoma in the head and neck region: a single institution's experience of 247 cases over 19 years. Arch of Craniofac Surg. 2016 ;17(2):56.

-Choi JH, Kim YJ, Kim H, Nam SH, Choi YW. Distribution of Basal cell carcinoma and squamous cell carcinoma by facial esthetic unit. Arch of Plast Surg. 2013; 40(4):387.

-Bieniek A, Matusiak ?, Chlebicka I, Szepietowski JC. Secondary intention healing in skin surgery: our own experience and expanded indications in hidradenitis suppurativa, rhinophyma and non?melanoma skin cancers. JEADV. 2013; 27(8):1015-21.s

-Olander J, Wong M, Brown M. Use of a Single Anatomic Donor Site for Harvesting a Full-Thickness Skin Graft and a Free Cartilage Graft for Nasal Defects. Dermatol. Surg. 2018 ;44(7):1023-4

-Salgarelli AC, Bellini P, Multinu A, et al. Reconstruction of nasal skin cancer defects with local flaps. J. Skin Cancer. 2011;2011.

-Cox A, Fort M. Nasal reconstruction involving multiple subunit defects. Facial Plast Surg. 2017 ;33(01):58-66.

-Vishnoi JR, Misra S. Loco regional flaps a boon for Surgeons in Head and Neck Reconstruction even in the Era of Microvascular flaps. Indian J. Surg. Oncol. 2019:1-2.

- Eren E, Beden V. Beyond Rieger's original indication; the dorsal nasal flap revisited. J Craniomaxillofac Surg. 2014 ;42(5):412-6.

-Jena A, Gangasani R, Reddy N, Patnayak R. Reconstruction with dorsal nasal flap after excision of basal cell carcinoma of the nose. J Cutan Aesthet Surg. 2017;10(1).

- Lu GN, Kriet JD, Humphrey CD. Local cutaneous flaps in nasal reconstruction. Facial Plast Surg. 2017 ;33(01):27-33.

- Rieger RA. A local flap for repair of the nasal tip. Plast Reconstr Surg. 1967;1;40(2):147-9.

- Marchac D. Lambeau de rotation frontonasal. Ann. Chir. Plast. 1970; 15:44-9.

- De Fontaine S, Klaassen M, Soutar DS. Refinements in the axial frontonasal flap. Br J Plast Surg. 1993; 46(5):371-4.

- Rohrich RJ, Muzaffar AR, Adams JW, Hollier LH. The aesthetic unit dorsal nasal flap: rationale for avoiding a glabellar incision. Plast Rreconstr Surg. 1999; 104(5):1289-94.

- Parodi PC, De Biasio F, Cordaro ER, Candiani M, Riberti C. Frontonasal myocutaneous flap based on the transversus nasalis muscle. Plast Reconstr Surg. 2005 ;115(6):1684-8.

- Larrabee YC, Phillips DJ, Sclafani AP. Trends in nasal subunit reconstruction by facial plastic and reconstructive surgeons. Facial Plast Surg. 2017; 33(01):017-9.

- Aldosari BF. The Axial Frontonasal Flap for Nasal Tip Defect: A Single Centre Experience. Cureus. 2019 ;11(10).

- McCluskey PD, Constantine FC, Thornton JF. Lower third nasal reconstruction: when is skin grafting an appropriate option? Plast Reconstr Surg. 2009 ;124(3):826-35.

- Kemler MA. Two-Year Evaluation of Either Bilobed Flap or Full Thickness Skin Graft as a Closure Technique of the Nasal Tip. J Dermatol Res Ther. 2016; 2:038.

- Bitgood MJ, Hybarger CP. Expanded applications of the dorsal nasal flap. Arch Facial Plast Surg. 2007 ;9(5):344-51.

- Manchot C. The cutaneous arteries of the human body. Springer; 2013.

- Niemann K, Lazarus L, Rennie C. An Anatomical Study of the Facial Artery. Int J Morphol. 2019 ;37(4).

- Pilsl U, Anderhuber F. The external nose: The nasal arteries and their course in relation to the nasolabial fold and groove. Plast Reconstr Surg. 2016;138(5):830e-5e.