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Nasal tip defects: satisfaction with Rintala flap for reconstruction—a report of 38 cases

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Reconstruction of nasal tip defects is challenging due to the prominence of the nose and scarce local tissue. There are several well-known local flaps for tip reconstruction. The Rintala flap, a sliding axial musculocutaneous flap from the nasal dorsum, can be used without distorting adjacent tissues and preserves the nasal subunit’s integrity. Although other case series confirmed viability and proposed modifications, patient-reported outcome measures (PROMs) have not been previously reported.We set out to confirm the suitability of the Rintala flap for the reconstruction of nasal (supra) tip defects and describe patient satisfaction with this specific reconstruction.

Methods

We present a case series involving 38 patients from two Dutch centers between 2010 and 2020. After tumor excision on the nasal tip or dorsum, defects were reconstructed using the Rintala flap. Patient-reported outcome measures (PROMs) were collected using the FACE-Q skin cancer module, evaluating various aspects of health-related quality of life.

Results

There were no cases of flap necrosis, tip rotation, or glabellar flattening in this series. FACE-Q scores showed high overall satisfaction with facial appearance and scars.

Conclusions

The Rintala flap should be considered a reconstructive option for patients with defects of the nasal dorsum up to 1.5 cm in size, particularly for patients who desire elevation of the nasal tip. It is a simple, one-step procedure that produces reliable aesthetic results and leaves the forehead intact as a donor site for future reconstruction.The Rintala flap has distinct advantages in reconstructing nasal tip defects with excellent FACE-Q scores.

Level of evidence: Level IV, therapeutic / prognostic study

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Data availability

All data are available through the corresponding author.

Code availability

Not applicable

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Authors and Affiliations

  1. Patient-Reported Outcomes, Value & Experience (PROVE) Centre, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Maarten J. Ottenhof

  2. Department of Surgery, Harvard Medical School, Boston, MA, USA

    Maarten J. Ottenhof

  3. Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands

    Maarten J. Ottenhof, Mara Z. Meulendijks, Aimee Lardinois, Dionne Deibel & Maarten Hoogbergen

  4. Department of Plastic and Reconstructive Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands

    René van der Hulst

  5. Department of Plastic and Reconstructive Surgery, Rode Kruis Hospital Beverwijk/Spaarne Gasthuis Haarlem, Beverwijk, The Netherlands

    Wouter van der Pot

Authors
  1. Maarten J. Ottenhof
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  2. Mara Z. Meulendijks
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  3. Aimee Lardinois
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  4. Dionne Deibel
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  5. René van der Hulst
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  6. Wouter van der Pot
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  7. Maarten Hoogbergen
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Corresponding author

Correspondence to Maarten J. Ottenhof.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of our institutions approved this study (N17.119).

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Informed consent was obtained from all participants included in the study.

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Patients signed informed consent electronically regarding publishing their data and photographs.

Conflict of interest

Maarten J Ottenhof, Mara Z. Meulendijks, Aimee Lardinois, Dionne Deibel, René van der Hulst, Wouter van der Pot, and Maarten Hoogbergen declare no competing interests.

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Ottenhof, M.J., Meulendijks, M.Z., Lardinois, A. et al. Nasal tip defects: satisfaction with Rintala flap for reconstruction—a report of 38 cases. Eur J Plast Surg 45, 741–745 (2022). https://doi.org/10.1007/s00238-021-01924-z

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  • DOI: https://doi.org/10.1007/s00238-021-01924-z

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