Comparative Study of Frontal and Nasolabial Flaps for Total Alar Subunit Reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Otolaryngology

Background:

• Total alar nasal subunit reconstruction is a complex procedure following trauma or cancer surgery.
• The nasolabial flap (NLF) and paramedian forehead flap (PFF) are common reconstructive options.
• Comparing the aesthetic and functional outcomes of NLF versus PFF is crucial for patient care.

Purpose of the Study:

• To compare the aesthetic and functional results of the NLF and PFF for total alar nasal subunit reconstruction.
• To evaluate patient satisfaction and objective outcome measures for both techniques.
• To inform surgical decision-making based on patient priorities and procedural complexity.

Main Methods:

• A prospective, monocentric study included 28 patients undergoing total alar reconstruction.
• Patients were divided into two groups: those receiving a folded PFF or an NLF.
• Outcomes were assessed using patient satisfaction surveys and the Nasal Aesthetic and Functional Evaluation Questionnaire.

Main Results:

• The PFF group achieved significantly higher aesthetic scores (30/35) compared to the NLF group (21.6/35; P=0.01).
• No significant functional differences were observed between the two flap types.
• The PFF required more operative stages (mean 3.6) than the NLF (mean 1.4; P<0.001), influencing patient choice.

Conclusions:

• The PFF provides superior aesthetic outcomes for alar reconstruction but involves greater complexity than the NLF.
• An individualized, patient-centered approach is essential, balancing aesthetic desires with the surgical burden.
• Shared decision-making is key to optimizing reconstructive choices for alar subunit defects.