Total Nasal Reconstruction
Utility of the Free Radial Forearm Fascial Flap
Catherine P. Winslow, MD;
Ted A. Cook, MD;
Alan Burke, MD;
Mark K. Wax, MD
Arch Facial Plast Surg. 2003;5:159-163.
Background Total nasal defects present daunting challenges to the reconstructive surgeon. The nasal skeleton can be successfully fabricated with bone and cartilage. Reconstruction of the nasal skin with a forehead flap produces an excellent color match for nasal skin. Resurfacing of the internal lining is the most difficult of the 3 layers. Local tissue is often unsatisfactory in amount and/or vascular supply.
Methods A patient requiring total nasal reconstruction was prospectively examined. Intraoperative technique was recorded, and postoperative function was determined.
Results A paramedian forehead flap was used to resurface the external defect. Split calvarium and conchal cartilage were used to reconstruct the nasal skeleton. A fascial flap harvested from the forearm was used to replace the intranasal lining. Turbinate grafts were placed to line the flap. Postoperative breathing was excellent.
Conclusions The intranasal portion of a total nasal defect can be successfully reconstructed with a fascial forearm flap. Placement of a turbinate or mucosal graft allows for a thin mucosalized lining with an excellent functional outcome.
From the Section of Otolaryngology, Department of Surgery, Walter Reed Army Medical Center, Washington, DC (Dr Winslow); and the Department of Otolaryngology, Oregon Health Sciences University, Portland, Ore (Drs Cook, Burke, and Wax).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Update on Major Reconstruction of the Head and Neck
Wax et al.
Arch Facial Plast Surg 2007;9:392-399.
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