ABSTRACT
Background: Several local flaps have been introduced for the reconstruction of small-to-medium-sized nasal supratip defects.Objective: To evaluate the outcome of reconstructing supratip defects using tangential advancement flaps from the vertical alar groove tissue.Methods and materials: Medical records of 20 patients who underwent supratip reconstruction using this flap between January 2012 and July 2018 were retrospectively analyzed. The postoperative photographs were assessed by three dermatologists using a four-scale investigator's global assessment.Results: The male-to-female ratio was 9:11, with a mean age of 72.6 years (range, 56-89 years). In all 20 cases, defects were caused by a wide local excision of non-melanoma skin cancer on the nose. The mean diameter of the defects was 1.20 cm (ranging from 0.5 to 1.9 cm). The mean follow-up period was 14.0 months (ranging from 0.5 to 48 months). Excellent or good surgical outcome was reported in 95% of patients.Conclusions: Creating a tangential advancement flap using the vertical alar groove tissue is a simple, single-stage procedure with excellent surgical outcome. It may be useful in the reconstruction of supratip defects with a diameter of less than 2 cm.
Subject(s)
Nose Neoplasms/surgery , Nose/surgery , Rhinoplasty/methods , Surgical Flaps , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Objective To investigate the effects of nasal tip reduction with inner incision combined with external fixation,namely,to evaluate the formation of bilateral alar groove which is en hanced by external fixation with small splints,after removing interdomal fat pad as well as adjusting alar cartilage to reduce nasal tip.Methods Alar cartilage and interdomal fat pad were exposed via the bilateral nasal vestibular incision to remove fat pad and part of enlarged lateral foot of alar cartilage.After suture of incision,based on the tissue removal,plastic splint was used for external fixation of bilateral nasal tip and alar groove for one week,to enhance the formation of alar groove.Results A total of 143 patients were followed up for more than 6 months after operation.Photographs taken before and after operation were compared,suggesting obviously smaller nasal tip and significant alar groove.Left and right alar groove space was decreased from preoperative (28.23±3.31) mm to post operative (23.72±2.65) mm,and nasal tip alar angle was decreased from (104.02±9.57)°to (87.78± 6.98)°,with statistical significance (P＜0.05).Slightly asymmetric nasal alars were found in 6 patients during follow-up examination,while tiny scars caused by splints (at 0.6 cm from the edge of splints) were found in 1 patient.Conclusions On the basis of nasal tip reduction with inner incision,the method of suture with small splints combined with external fixation is simple,effective and available.
ABSTRACT
Various methods of nasal reconstruction were performed over time. The physiology and anatomy of nose were clarified and its aesthetic subunits were employed, more improvement and modification were performed. The bilobed flap is particularly suitable for reconstruction of small or medium sized nasal defect up to 1.5 cm in diameter. Authors performed 6 cases of the bilobed flap for the defect of nasal dorsum (4 cases: basal cell carcinoma, 2 cases: compound nevus) from March 2000 to February 2001. The bilobed flap was medially based and second lobe was positioned on the nasal alar groove. This flap results in little or no distortion around tissue, by which scars of nasal dorsum and dog-ear deformity are reduced. Moreover we could achieve better cosmetic results for the scar, primary repair site of the second lobe, which is concealed by nasal alar groove.
