Nose defects reconstruction with the Zitelli bilobed flap

The skin cancers of the head and neck district are localized mostly on the nose, which, by being in the center of the mid-face, has an important aesthetic role. Therefore, many reconstructive techniques have been studied; among them regional skin flaps appeared the most suitable since they guaranteed the oncological radicality as well as a good aesthetic outcome. In this paper, we present our experience with the use of the Zitelli bilobed flap, which is defined as a double transposition flap for the reconstruction of the nose defects. From 2008 to 2012, we have treated 86 patients (56 men and 30 women, aged between 47 and 83 years) for skin cancer of the nose (72% basal-cell carcinoma, 28% squamous cell carcinoma); for all patients, the nose defects' reconstruction was performed by means of the modified Zitelli bilobed flap. The results were evaluated by short- and long-term follow-up; no infections or major complication were reported, while high preservation of the patient's facial characteristics and normal functions of the nose were observed. In 12 cases, little distortions of the alar rim were recorded although these patients still evaluated the cosmetic outcome as good. In our experience, the Zitelli bilobed flap remains a robust and reliable tool for the reconstruction of the nose defects, since it preserves its function, while ensuring a good aesthetic result.