Nasal reconstruction: our experience

The nose is a critically important aesthetic and functional portion of the face. We can explore nasal defects following trauma or tumor resections. Reconstructive techniques based on primary closure, skin graft, local flap, regional flap and microvascular free tissue transfer provides an algorithmic framework applicable to any reconstructive problem. From 2010 to 2016, 33 patients were treated with nasal reconstruction. Malignant tumor resection was the main cause of nasal defect. The most common tumor resected was BCC (basal cell carcinoma) followed by SCC (squamous cell carcinoma). Recurrence of malignant tumor were also treated. As described in the literature, we used the most common reconstructive techniques to handle post-resection defects. Most of the defects involved the dorsum and the ala of the nose, only rarely had the skeleton been affected by the resection. When the cartilage had been sacrificed, a graft from the septum or from the ear flap was harvested. All patients resulted in optimal reconstruction. In any case, a second surgery was needed. All the surgical procedures were performed in one single stage except for the paramedian forehead flap that required a second stage for division and inset of the flap. All donor sites did not show functional and aesthetic damage. All patients resulted in a morpho-functional restoration of the area affected by the resection with a high success rate. Following the algorithm when restoring the anatomical subunit is the base purpose has determined satisfactory results.