Alternative 1-Step Nasal Reconstruction Technique

作者：Kishi Kazuo^*; Imanishi Nobuaki; Shimizu Yusuke; Shimizu Ruka; Okabe Keisuke; Nakajima Hideo

来源：Archives of Facial Plastic Surgery, 2012, 14(2): 116-121.

DOI：10.1001/archfacial.2011.1402

Objective: To describe a 1-step nasal reconstruction technique for use in lieu of a paramedian forehead flap that is usually raised at the location of the supratrochlear artery.
Methods: Using angiography in 10 fresh cadavers, we confirmed the arterial anatomy of the nasal and forehead regions to refine the paramedian forehead flap. Based on the anatomical data, we performed nasal reconstruction in 6 patients who had a full-thickness defect of the nasal ala or who needed alar base reconstruction with an island paramedian forehead flap based on the angular artery.
Results: From the anatomical study, we confirmed a rich network among the supratrochlear, dorsonasal, and angular arteries around the medial canthus. In the clinical cases, the subcutaneous pedicle was tunneled beneath the skin, without conspicuous bulkiness. For all patients, the operation was completed in 1 stage, and the flaps healed without evidence of necrosis.
Conclusions: By moving the pedicle downward, a full-thickness nasal defect can be reconstructed in 1 stage that includes the alar lining or alar base with the paramedian forehead flap. This avoids restriction of the rotation arc, particularly when the alar lining or alar base is also needed for reconstruction.

• 出版日期2012-4