Staged Bilateral Nasal Alar Reconstruction with Free Vascularized Helical Root Flaps, Case Report

ABSTRACT

PURPOSE: Reconstruction of full-thickness defects of the nasal ala has always been a challenge. Local flaps can be used easily, and good result can be achieved when it is indicated. But local flaps often result in facial scars and bulky ala that require secondary revisions. Composite auricular chondrocutaneous graft may matches nasal alae well in terms of contour, color and texture, however, the size of composite graft is limited. We performed free vascularized helical root flaps for reconstruction of nasal ala. METHODS: Bilateral ala was excised and the defects were reconstructed with a chondrocutaneous free helical root flap. Each side of ala was reconstructed in 3 months interval. Superficial temporal vessels of vascularized helical root flap were anastomosed to facial vessels. Great saphenous vein was used for interpositional vascular graft. RESULTS: Flaps survived successfully. The contour, texture and color match were satisfactory. Functional problem of nasal obstruction caused by scar stenosis of nostrils was also resolved. CONCLUSION: The free vascularized helical root flap is a reliable method in reconstruction of nasal alar defects. The donor deformity was minimal.