[Total nasal reconstruction by folded forearm radial flap: Technical note].

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Facial Anatomy

Context:

• Total nasal reconstruction is a complex procedure with significant patient implications.
• Restoring all three anatomical planes while preserving respiratory function is crucial.
• Existing techniques present challenges in achieving optimal functional and aesthetic results.

Purpose:

• To evaluate the efficacy of a combined folded microanastomosed radial forearm flap (FRFF) and paramedian forehead flap technique for total nasal reconstruction.
• To detail the technical aspects and assess aesthetic outcomes of this surgical approach.
• To analyze functional and aesthetic results using the NAFEQ score.

Summary:

• A retrospective study analyzed 6 total nasal reconstructions using the FRFF and paramedian forehead flap (PF) technique.
• Mean substance loss was 5.5cm, with functional and aesthetic NAFEQ scores of 82% and 88% respectively.
• Necrosis occurred in 16% of cases due to thrombosis, with a mean follow-up of 6 months.

Impact:

• The combined FRFF and PF technique is optimal for total nose reconstruction.
• This approach provides adequate cartilage projection and good nostril conformation.
• The technique demonstrates favorable functional and aesthetic results, enhancing patient outcomes.