ABSTRACT
BACKGROUND: The subcutaneous pedicled nasolabial flap is a useful material for alar reconstruction. OBJECTIVE: This article describes the difficulties and considerations in this procedure and discusses the procedural problems involved, drawing conclusions from them. METHODS: Case 1: a folded flap was used with a conchal cartilage strut sandwich. Case 2: only a folded flap was used. Case 3: the flap was used to cover the outer surface of the ala, and a mucoperiosteal graft from the hard palate was used for the ala lining. RESULTS: The cartilage strut was not sufficient to support the shape of the ala in case 1. Harvesting a sufficiently wide flap is thought to be important. However, a folded flap had some drawbacks, with the formation of a thick alar rim. CONCLUSIONS: The combination of a flap for the outer surface and a mucoperiosteal graft as a lining is thought to be an excellent option for alar reconstruction.
Subject(s)
Face/blood supply , Rhinoplasty/methods , Surgical Flaps , Aged , Carcinoma, Basal Cell/surgery , Female , Humans , Male , Middle Aged , Mohs Surgery/methods , Nose Neoplasms/surgery , Treatment OutcomeABSTRACT
BACKGROUND: Elephantiasis nostras verrucosa represents a rare group of cutaneous changes comprising dermal fibrosis, hyperkeratotic, verrucous, and papillomatous lesions after chronic secondary, nonfilarial lymphedema. There is no standard treatment for this rare cutaneous manifestation. OBJECTIVE: This article describes debridement that is helpful when performed in addition to physiotherapy. METHODS: We present a patient who was treated by shaving the verrucous area with a blade of a freehand knife and by subsequent abrading of the mossy area using a motor-powered grinder. RESULTS: Reepithelization was completed in 2 weeks. A compression stocking was used to treat the lymphedema. Ten months after the operation, we saw no signs of disease recurrence. The result was also aesthetically satisfactory. CONCLUSIONS: Surgery in such case may not always be the best treatment because it does not treat the cause of disease but only treats the cutaneous symptoms. Nevertheless, debridement is a rapid and an aesthetically acceptable form of treatment.
