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Summary
This summary is machine-generated.

This study presents a novel two-stage technique for nasal reconstruction using a paramedian forehead flap and septal cartilage, achieving successful cartilage reconstruction in the first stage. The method ensures aesthetic and functional outcomes for nasal vault deficiencies without compromising vascularity.

Keywords:
Paramedian fore head flapRhinoplastySeptal mucoperichondrial flapSingle stage

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Area of Science:

  • Plastic Surgery
  • Otorhinolaryngology
  • Reconstructive Surgery

Background:

  • Interpolated flaps, particularly the paramedian forehead flap, are standard for nasal reconstruction.
  • Current techniques often require multiple stages for aesthetic and functional nasal vault reconstruction.
  • Achieving simultaneous skin and cartilage reconstruction without vascular compromise remains a challenge.

Purpose of the Study:

  • To describe a modified two-stage reconstructive nasal procedure incorporating simultaneous cartilage reconstruction.
  • To evaluate the efficacy and safety of using a paramedian forehead flap with ipsilateral septal perichondrium and cartilage.
  • To address lower nasal vault deficiencies in a single operative setting.

Main Methods:

  • A retrospective review of 4 patients with lower nasal vault deficiency who underwent a two-stage reconstructive procedure.
  • Utilized an ipsilateral paramedian forehead flap combined with ipsilateral septal perichondrium and septal cartilage for reconstruction.
  • Flap division occurred after three weeks, with subsequent thinning as needed.

Main Results:

  • All patients achieved complete flap uptake with no instances of cartilage necrosis.
  • No patient reported increased nasal obstruction post-operatively compared to pre-operative levels.
  • The average Nasal Obstruction Symptom Evaluation (NOSE) Visual Analog Scale (VAS) score was 17.5 one month after the second stage.

Conclusions:

  • This two-stage technique effectively integrates cartilage reconstruction within the initial flap harvest.
  • The method provides robust nasal subunit reconstruction, enhancing both airway and nasal valve support.
  • Careful planning and flap selection are crucial for successful and cosmetically superior nasal reconstruction.