Management of Frontal Bone Exposure Following Paramedian Forehead Flap for Nasal Reconstruction

Frances K Salisbury ¹, Zachary A Koenig ², Halil S Uygur ²

⁰School of Medicine, West Virginia University.

The Journal of Craniofacial Surgery +

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October 25, 2024

View abstract on PubMed

Summary

This case study details managing frontal bone exposure after paramedian forehead flap reconstruction for nasal defects. Innovative surgical techniques achieved successful wound closure and cosmetic results.

Area Of Science

Reconstructive Surgery
Plastic Surgery
Dermatologic Surgery

Background

Paramedian forehead flaps are versatile for nasal reconstruction.
Recipient site morbidity is commonly discussed, but frontal bone exposure is a rare complication.
Risk factors include periosteal damage during surgery or desiccation during secondary healing.

Purpose Of The Study

To report a case of frontal bone exposure following nasal reconstruction with a paramedian forehead flap.
To describe the management and successful resolution of this rare complication.
To highlight the importance of adaptive surgical strategies and postoperative care.

Main Methods

Nasal reconstruction using a paramedian forehead flap for an extensive defect after Mohs surgery.
Management of exposed frontal bone prior to pedicle division included burring the bone and applying a dermal regeneration matrix.
Split-thickness skin grafting from the thigh was performed at 4 weeks postoperatively.

Main Results

Successful wound closure with 100% graft take.
Acceptable cosmetic outcome achieved.
Demonstrated effective management of a rare complication.

Conclusions

Frontal bone exposure is a rare but manageable complication of paramedian forehead flap reconstruction.
Innovative surgical interventions and meticulous postoperative care are crucial for successful outcomes.
This case contributes to understanding adaptive strategies in reconstructive surgery.