Double forehead flap reconstruction of composite nasal defects

Area of Science:

• Plastic Surgery
• Otolaryngology
• Head and Neck Surgery

Background:

• Composite nasal defects necessitate reconstruction of skin, framework, and lining.
• Forehead flaps are ideal for skin coverage due to color match and healing.
• Existing lining reconstruction methods have limitations for large defects.

Purpose of the Study:

• To evaluate the efficacy of the double forehead flap for reconstructing large composite nasal defects.
• To present a surgical technique for nasal reconstruction in specific patient populations.

Main Methods:

• Six patients (3 male, 3 female; average age 74.7 years) with large nasal defects (>2 cm) underwent reconstruction.
• Defects resulted from cancer (5) or trauma (1).
• Double forehead flaps were raised simultaneously or in stages, with multi-stage reconstruction.

Main Results:

• Follow-up averaged 19.3 months.
• Donor site healing varied (3 months for staged, 7.6 months average for simultaneous).
• No flap loss, infection, hematoma, or nerve injury occurred; all patients achieved satisfactory aesthetic results.

Conclusions:

• The double forehead flap is advocated for large composite nasal defects in select patients.
• It is a suitable option for those ineligible for nasolabial flaps or free tissue transfer.
• Consideration of prolonged donor-site healing and loss of contralateral flap is necessary.