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Published on: September 29, 2018
[Nasal alar reconstruction with a vascularized free auricular composite flap]
Yun-liang Qian1, Yi-xin Zhang, Yu-guang Zhang
1Department of Plastic and Reconstructive Surgery, Ninth People's Hospital, Shanghai Second Medical University, Shanghai, China. wangdanru2002@yahoo.com
Objective:
The plastic surgeons prefer to reconstruct nasal alar with free auricular composite flap because it well matches nasal tissue in contour, texture and color. However, the size of the free composite flap should be less than 1. 0 cm x 1.5 cm due to the limitation of revascularization. Our aim is to search for a surgical method which could be used to repair full-layer larger nasal alar defects.
Methods:
A surgical technique was presented to repair nasal alar defect with a free auricular composite flap, which was vascularized by branches of superficial temporal artery. Briefly, the contralateral auricular composite tissue pedicled by superficial temporal vessels (3 to 4 cm in length) was harvested from region of helix crus and preauricular skin, which matched the arc of the nasal rim, and then transplanted onto the recipient area. The superficial temporal vessel pedicles were anastomosed to facial vessels via vessel grafts harvested from lateral circumflex femoral vessels, which were about 10 to 12 cm in length.
Results:
Twelve cases were treated, among them, 11 cases were successfully repaired with satisfactory results, one case failed, possibly due to the bad condition of the patient's blood vessels. In our cases, the size of alar defect varied from 1.5 cm x 2.5 cm to 2.0 cm x 3.8 cm. The minimal auricular donor site deformities and inconspicuous scar were acceptable and could easily be hidden by hair.
Conclusions:
The technique of free auricular composite flap, which is vascularized by superficial temporal vessels, is ideal for nasal alar reconstruction.
