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A Surgical Strategy for Three-Layer Structure Reconstruction in Total Nasal Defect
Bao-Fu Yu1, Jiao Wei1, Chuan-Chang Dai1
1Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Journal of Clinical Medicine
|July 28, 2026
Summary
This study presents a new three-layer technique for total nasal reconstruction using radial forearm, extended framework, and forehead flaps. The method achieved successful structural and aesthetic outcomes in ten patients, offering a viable option for complex cases.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Otolaryngology
Background:
- Total nasal reconstruction remains a significant surgical challenge with no universally accepted protocol.
- Existing methods often lack comprehensive, evidence-based guidelines for clinical practice.
Purpose of the Study:
- To introduce and evaluate a novel three-layer technique for total nasal reconstruction.
- To assess the structural, functional, and aesthetic outcomes of this reconstructive approach.
Main Methods:
- A three-layer reconstruction technique involving a radial forearm flap for mucosal lining, an extended framework for structural support, and an expanded forehead flap for external skin coverage.
- Ten patients with full-thickness nasal defects underwent the procedure, with outcomes assessed over a 12-36 month follow-up period.
Main Results:
- Successful structural and functional restoration was achieved in all ten patients.
- Primary wound healing occurred within 10-22 days, with satisfactory aesthetic results reported by patients and surgeons.
- Objective functional assessments confirmed no significant impairment in nasal airflow.
Conclusions:
- The described three-layer surgical strategy is a rational and clinically viable approach for total nasal reconstruction.
- This technique provides a valuable reference for surgeons managing complex nasal defects.
- The study highlights the potential for improved outcomes in total nasal reconstruction.