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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction

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A composite buccal flap for alar based defect reconstruction: a technical note.

F Pourdanesh¹, A Khojasteh

¹Assistant Professor, Department of Oral and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Journal of Dentistry (Tehran, Iran)

|April 18, 2012

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Reconstructing nose alar defects with cartilage is challenging. This case study details a successful alar reconstruction using a composite auricular graft over a pedicle buccal flap for traumatic childhood alar loss.

Area of Science:

Plastic Surgery
Otolaryngology
Reconstructive Surgery

Background:

Alar defects, particularly those involving cartilage, present significant reconstructive challenges.
Traumatic alar loss in childhood requires specialized surgical approaches for optimal functional and aesthetic outcomes.

Purpose of the Study:

To report a novel technique for alar reconstruction in a pediatric patient with traumatic alar loss.
To evaluate the efficacy and long-term results of using a composite auricular graft with a pedicle buccal flap.

Main Methods:

A composite auricular graft, including skin and cartilage, was harvested from the auricular region.
A pedicle buccal flap was prepared, rotated, and tunneled intraorally to provide lining for the alar defect.
The composite auricular graft was placed over the pedicle buccal flap to reconstruct the alar defect.

Keywords:

Alar Reconstruction Buccal Graft Composite Graft

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All surgical procedures were performed under general anesthesia.

Main Results:

The alar reconstruction using the described technique yielded satisfactory aesthetic and functional results.
A one-year follow-up demonstrated minimal graft contracture, indicating the durability of the reconstruction.
The intraoral approach for the buccal flap provided adequate lining and support for the graft.

Conclusions:

This combined technique of a composite auricular graft over an intraoral pedicle buccal flap is a viable option for reconstructing complex alar defects.
The method offers a good balance of aesthetic and functional restoration, even in cases of significant cartilage involvement and childhood trauma.