Forehead flap: master techniques in otolaryngology-head and neck surgery

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Otolaryngology

Background:

• Nasal defects significantly impact patients' appearance and function.
• Reconstructing the nose presents challenges due to dissimilar donor tissues and inaccurate wound representation.

Observation:

• Subunit principles and donor tissue modification are crucial for satisfactory nasal reconstruction.
• Major reconstructions often necessitate late revisions for scar improvement, asymmetry correction, or airway patency.

Findings:

• Grossly deficient cover or lining may require a complete repair with a second regional flap.
• Successful nasal reconstruction depends on meticulous preoperative analysis and a well-defined surgical plan.
• Small defects can be addressed in two stages using a forehead flap; large, deep defects benefit from a three-stage approach.

Implications:

• A staged approach allows for precise placement of cartilage grafts and soft tissue sculpting.
• Intermediate operations in multi-stage reconstructions facilitate folded flap lining replacements.
• Careful planning and execution are key to achieving functional and aesthetic nasal restoration.