Nasal reconstruction

Congenital malformations, trauma, benign or malignant tumors may call for reconstructive surgical procedures to cover the defect. In order to establish a proper diagnosis a careful examination including X-rays and biopsies is mandatory. A close contact with with the radiotherapist is most desirable in order to combine the therapy if necessary. After the excision of scars or growth, we differentiate between three phases of treatment: 1. The immediate reconstruction either by local flaps or by free grafts. 2. The delayed excision of the tumor after the establishment of the proper diagnosis. This waiting period (two to three weeks) is used to preform the missing nasal parts in the vicinity of the lesion either on the cheek or forehead. Rib cartilage with split skin grafts or composite grafts is used for this purpose. After the excision of the tumor the nasal reconstruction is carried out during the same operation. 3. Tumor excision and coverage of the raw surface with split grafts in order to inspect the area for several months for any recurrence and the delayed reconstruction with adjacent or distant flaps. The operative techniques are described.