Reconstruction of total and subtotal nose defects

Reconstruction of nose defects after tumor resection, trauma or infection disease is imperative for full patient rehabilitation. For satisfying esthetic and functional results achievement, it is necessary to use surrounding skin with similar semblance, which precisely restores and imitates missing part with its outlines.

This paper represents management of the patients with subtotal and total nose defects using forehead and nasolabial flaps. During a period from 2007 to 2010, 20 patients with total or subtotal nasal defects were observed. Among them, 6 defects had traumatic etiology and 14 of them resulted after tumor resection. All of them were full thickness defects overtaking the nasal mucosa, skin of the nasal antechamber, cartilage frame and external nasal skin. In all cases there was indication for local flap reconstruction. Median forehead flap has been used in 12 cases and nasolabial flap in 6 cases. Combination of these two flaps has been used in 2 cases.

Good and satisfying results were achieved in all of 20 cases, except for one speech dysfunction. Nose function was maintained with proper porosity of the nostril. Three-dimensional appearance of the nose was reconstructed with achievement of acceptable esthetics results.

Because of its good vascularisation, adaptability, color and outlining without hair, nasolabial and median forehead flap, as well as surrounding area flaps are the most frequent used flaps in nose defect reconstruction.