Flaps used for nasal reconstruction: a perspective based on 180 cases

Flap reconstruction of the nose is historically one of the earliest surgical operations. In spite of this long experience, little has been reported on the viability and durability of the various flaps and the time involved in the reconstruction, including the number of operative procedures required for total reconstruction of the nose. One hundred eighty patients were involved in this retrospective study dating from 1940. The midline forehead flap, used for partial nasal reconstruction, was specifically excluded from this study and will be reported separately later. The arm flap (Tagliacozzi), the total forehead flap, the sickle flap, and the acromiopectoral flap are reviewed in terms of the complications encountered, the total number of operations required, and the time involved in the complete reconstruction. The various nasal defects have been classified into five types, and the flaps usually used for reconstruction have been correlated with these defects. Eighty percent of the patients were treated because of a cutaneous malignancy of the nose. However, because these malignancies are currently being treated earlier and more efficiently, there is a significant decrease in present-day experience with this type of surgery.