Nasal reconstruction

SUMMARY: Nasal reconstruction in pediatric patient is very challenging and it requires consideration of later nasal development. Herein, we introduce an innovative preauricular free flap pedicled with retrograde vascular (PFFPRV) for pediatric nasal reconstruction. In this PFFPRV technique, the retrograde superficial temporal vessels were used as the flap pedicle. The lateral alar artery and angular vein were used as vessels of the nasal recipient zone. The flap vessels were anastomosed directly to the recipient area vessels without additional vessel transplantation...

INTRODUCTION: A supernumerary nostril is one of the rarest congenital nasal abnormalities. Recently we encountered a 16-months-old patient with 3 supernumerary nostrils that was located at left side of the nose and performed an operation on this case. We reported a rare case of three supernumerary nostril located at left side of the nose. CASE PRESENTATION: A 14-month-old male baby was referred to our clinic for assessment of a nose deformity. Physical examination revealed an asymmetrical ala of nose with 3 supernumerary nostrils at left side and a normal right nostril...

Nasal reconstruction after skin cancer excision has routinely been challenging without any aesthetic sequelae, and any defects on the nose are readily noticeable. To circumvent this problem, surgeons have developed different flap techniques to mobilize adjacent tissue to repair aesthetically sensitive defects. We describe our experience, outcomes, and valuable tips for using the "tree flap," a novel modification of the hatchet flap that extends the back cut to significantly increase mobility, leaving only a small skin paddle to maintain perfusion to the flap...

We present the case of a 55-year-old male patient who came to our attention because of a basal cell carcinoma of the right retroauricolar area, near the mastoid-auricle border. The tumor had a size of about 1.5 cm. Repairing retroauricolar surgical defects may be actually very challenging, firstly because an incorrect reconstruction may result in severe deformities which are extremely hard to conceal; so, we decided to employ the "jigsaw puzzle" advancement flap, a versatile flap, firstly successfully used in the reconstruction of a nasal ala defect...

BACKGROUND: Autogenous costal cartilage becomes a favorable choice for nasal reconstruction and complicated aesthetic rhinoplasty, due to its ample supply, sufficient for most patients. However, a notable drawback is the potential for warping. Our study aims to identify cutting planes that minimize warping. MATERIALS AND METHODS: Two hundred and seven costal cartilage grafts were obtained by slicing the extracted costal cartilages from 10 fresh cadavers, along three main planes: cephalocaudal, anteroposterior, and parallel to the synchondrosis plane...

OBJECTIVES: A retrospective study was conducted on the effect of primary rhinoplasty on infants with unilateral complete cleft lip nasal deformity. METHODS: Infants with unilateral complete cleft lip in the Department of Cleft Lip and Palate Surgery, College of Stomatology, Xi'an Jiaotong University were selected. All infants underwent cheiloplasty and primary rhinoplasty. We reconstructed the nasal base and corrected the nasal septum and alar deformity at the same time...

(1) Background : The preferred reconstructive option for closing small- or medium-sized defects of the distal half of the nose is the use of local flaps. The dorsal nasal (Rieger) flap is suitable for closing medium-sized defects at this location, especially when they are medially located, and are wider rather than tall. We describe a rotation-transposition dorsal nasal flap reconstruction for large nasal defects. The novelty of this design includes the addition of a small transposition lobe to the rotation flap, enabling the acquisition of tissue from either the lateral sidewall or the nasolabial sulcus, facilitating closure with guitar-string sutures...

No abstract text is available yet for this article.

PURPOSE: This article outlines the management of a rare and severe nasoorbital injury resulting from a chainsaw kickback accident in a 60-year-old male. A meta-narrative review of English, French, and German literature indexed in PubMed, Embase, and the Cochrane Library up to January 8, 2024, accompanies the case report. METHODS: This was a case report combined with a comprehensive review based on the 2011 Oxford Centre for Evidence-Based Medicine's highest and most recent level of evidence (LoE) and highest recommendation grade (RG)...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Prosthetic nasal reconstruction provides a restorative option for patients with nasal defects, and these can be retained with a variety of methods including adhesives and implants. These prostheses can significantly improve appearance, self-esteem, and quality of life for patients and they restore many functions of the external nose. Traditional fabrication methods are often used by the skilled professionals who make these custom prostheses, but digital technology is improving the workflow for design and fabrication of silicone nasal prostheses...

Soft tissue injuries to the midface (and nose) are common causes for seeking trauma care. As trauma patients, observing advanced trauma life support protocols is warranted given the risk of concomitant injuries. Here, options for optimizing tissue preservation, microvascular replantation, non-microvascular tissue replacement, and wound stabilization are discussed. Included in this discussion are data-driven predictors for successful replantation as well as technique descriptions with anatomic references to guide surgeons in choosing optimal donor vessels...

Nasal reconstruction is a challenging practice with the potential for complications. Surgeons can prevent complications through preoperative optimization of patient factors, refinement of intraoperative surgical techniques, and postoperative surgical and nonsurgical wound care. Preoperatively, optimization of modifiable and recognition of nonmodifiable risk factors is paramount. Intraoperatively, meticulous flap design and surgical technique promote healing. In the postoperative setting, attentive wound care, adjuvant therapies, and close follow-up for consideration of additional procedures enhance outcomes...

Nasal reconstruction remains one of the most challenging surgeries for facial plastic and reconstructive surgeons. The addition of defects extending beyond the nose adds a layer of complexity to an already technically demanding surgery. This article will focus on the management of composite defects extending beyond the boundaries of the nose. Surgeons need to have a variety of techniques at their disposal. These complex defects often require multiple local flaps, multiple stages, and, in select cases, free tissue transfer...

Reconstructing the nose poses considerable challenges, even for the most skilled surgeons. Significant nasal reconstructions often require later revisions to address persistent issues in both form and function, and it is crucial to discuss this possibility with the patient before embarking on the reconstructive process. Minor revisions can often be managed by making direct incisions between nasal subunits, coupled with soft tissue sculpting or the use of structural grafts for augmentation. When minor adjustments prove insufficient, the initial reconstruction may need to be entirely revised with a second forehead flap...

The forehead flap is a time-tested and robust resurfacing flap used for nasal reconstruction. Owing to its excellent color and texture match, acceptable donor site morbidity, and robust and independent blood supply that can support both structural and internal lining grafts, this flap remains the workhorse flap for resurfacing large nasal defects. Various nuances of this technique relating to defect and template preparation, flap design, flap elevation, flap inset, donor site closure, and pedicle division are discussed in this article...

When large defects of the nose are present, it is imperative to address all 3 layers: the external skin envelope, the osteocartilaginous support, and the inner mucosal lining. The middle structural framework is the primary factor in determining the overall shape of the nose, in addition to facilitating a functional and patent airway. As such, its reconstruction must be robust enough to provide lasting osteocartilaginous support while minimizing disfiguring bulk. The goal is replacement of missing tissue with grafts of similar strength, size, and shape...

Total nasal reconstruction is a complex challenge due to the need to establish new internal lining, internal structural support, and external skin covering that is both functional and esthetic. The medial femoral condyle corticoperiosteal free flap represents an innovative option for restoration internal structure and internal nasal lining. When used in conjunction with a paramedian forehead flap, acceptable results in both function and esthetics can be achieved.

A successful nasal reconstruction relies heavily on a stable internal lining. Larger defects pose unique challenges for internal lining reconstruction as obtaining tissue of adequate size while maintaining airway patency is difficult. The prelamination technique uses a staged skin graft to the paramedian forehead flap prior to transfer. As such, a composite flap can be later transferred to reconstruct internal and external nasal defects concomitantly. This article reviews the current background, techniques, and clinical considerations in the use of the prelaminated forehead flap for nasal lining reconstruction in partial to total nasal defects...