Reconstruction of the Partial Soft Tissue Defect of the Nose

ABSTRACT

Reconstruction of total nasal defect is limited in methods, but in cases of partial nasal defect, various methods can be adapted according to the size, shape and location. The authors tried to summarize the relationship between the etiology, location, size of partial nasal defect and reconstructive methods. The authors experienced 27 patients of partial nasal defect for the recent 3 years, male patients were 13 and female patients were 14 among them. The age of the patients ranged from 27 to 78. Malignant skin tumor was the most common among the causes of the defect: 16 cases of basal cell carcinoma, 4 cases of squamous cell carcinoma. The locations of the defect can be summarized as 8 cases of nasal alar area, 8 cases of nasal tip area, 6 cases of nasal side wall and 5 cases of nasal dorsum. As reconstructive methods, the authors used median forehead flap in 7 cases, dorsal nasal flap in 6 cases, full thickness skin graft in 5 cases, bilobed local flap in 3 cases, nasolabial flap in 3 cases, and other local flap in 3 cases. Skin graft is an easy method for the shallow defect, but its major disadvantage is color mismatch with adjacent skin. In cases of flap surgery, though it often causes deformity in contour, appropriate reconstruction was possible with through preoperative evaluation. According to our survey, local flap such as bilobed flap was enough for the defect of small size, and in cases moderate to large sized defect, nasolabial flap was appropriate for defect in nasal tip area, dorsal nasal flap was good for the defect in nasal dorsum and median forehead flap was useful for the defect in nasal side wall. The authors presents our comparative results of the 27 cases of partial nasal defect for the recent 3 years with the hope of being contributed in choosing the reconsfructive methods in the future.