A compendium of intranasal flaps

Area of Science:

• Plastic Surgery
• Otolaryngology
• Head and Neck Surgery

Background:

• Intranasal defects often necessitate reconstructive surgery using grafts or flaps.
• Designing and utilizing flaps for intranasal reconstruction presents significant challenges, primarily due to limited surgical exposure within the nasal cavity and the intricate three-dimensional movement required for flap placement.

Observation:

• Surgical approaches like transoral premaxillary, lateral rhinotomy, and open rhinoplasty can enhance intranasal exposure.
• Flap design for intranasal reconstruction must account for complex three-dimensional movements, unlike typical two-dimensional surface flaps.

Findings:

• The review examines eight specific flap types used in intranasal reconstruction: mucoperichondrial advancement/rotation flaps, composite septal flaps, inferior turbinate flaps, nasal floor mucoperiosteal flaps, middle turbinate flaps, composite lateral cartilage flaps, buccal sulcus flaps, and nasolabial flaps.
• These flaps are designed based on fundamental skin flap principles but adapted for the unique three-dimensional spatial requirements of the nasal cavity.

Implications:

• Improved understanding and application of these flap techniques can enhance reconstructive surgery outcomes for intranasal defects.
• Further research into optimizing flap design and surgical approaches may lead to more predictable and successful reconstructions.