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Nasal reconstruction utilizing a muscle hinge flap with overlying full-thickness skin graft
D J Fader1, T S Wang, T M Johnson
1Department of Dermatology, University of Michigan Medical Center, Ann Arbor 48109-0314, USA.
Background:
Deep nasal defects of the dorsum, sidewall, and ala can be challenging to repair.
Objective:
The article describes our experience with a muscle hinge transposition flap with overlying local full-thickness skin grafting for repair of deep nasal defects in a single-stage procedure.
Methods:
A muscle hinge transposition flap with overlying local full-thickness skin grafting was used immediately after Mohs micrographic surgery to repair 12 deep nasal defects of the dorsum, sidewall, alar lobule, and supratip.
Results:
No cases of infection, flap, or graft necrosis occurred in our series. Cosmetic and functional outcomes were judged from good to excellent by patient and surgeon. To enhance the cosmetic outcome, 5 patients underwent spot dermabrasion within 2 months of repair.
Conclusion:
For properly selected small to medium-sized deep nasal defects (1-2 cm) that lack a sufficiently loose adjacent tissue reservoir for a single-stage local flap, a muscle hinge transposition flap with local full-thickness skin grafting can provide consistently satisfying aesthetic and functional results.