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CC BY-NC 4.0 · Arch Plast Surg 2013; 40(06): 748-753
DOI: 10.5999/aps.2013.40.6.748
Original Article

Through-and-through Nasal Reconstruction with the Bi-Pedicled Forehead Flap

Tommaso Agostini
Department of Plastic and Reconstructive Surgery, University of Florence, Faculty of Medicine and Surgery, Florence, Italy
,
Raffaella Perello
Department of Plastic and Reconstructive Surgery, University of Florence, Faculty of Medicine and Surgery, Florence, Italy
,
Giulia Lo Russo
Department of Plastic and Reconstructive Surgery, University of Florence, Faculty of Medicine and Surgery, Florence, Italy
,
Giuseppe Spinelli
Department of Plastic and Reconstructive Surgery, University of Florence, Faculty of Medicine and Surgery, Florence, Italy
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Background Nasal reconstruction is one of the most difficult challenges for the head and neck surgeon, especially in the case of complex full thickness defects following malignant skin tumor resection. Full-thickness defects require demanding multi-step reconstruction.

Methods Seven patients underwent surgical reconstruction of full-thickness nasal defects with a bi-pedicled forehead flap shaped appropriately to the defect. Patients were aged between 58 and 86 years, with a mean age of 63.4 years. All of the tumors were excised using traditional surgery, and in 4 of the patients, reconstruction was performed simultaneously following negativity of fresh frozen sections of the margins under general anesthesia.

Results Nasal reconstruction was well accepted by all of the patients suffering non-melanoma skin tumors with acceptable cosmetic outcomes. The heart-shaped forehead flap was harvested in cases of subtotal involvement of the nasal pyramid, while smaller defects were reconstructed with a wing-shaped flap. No cartilaginous or osseous support was necessary.

Conclusions This bi-pedicled forehead flap was a valid, versatile, and easy-to-implement alternative to microsurgery or multi-step reconstruction. The flap is the best indication for full-thickness nasal defects but can also be indicated for other complex facial defects in the orbital (exenteratio orbitae), zygomatic, and cheek area, for which the availability of a flap equipped with two thick and hairless lobes can be a valuable resource.

Keywords

Nose neoplasms - Nose deformities, acquired - Surgical flaps - Nasal surgical procedures - Nasal bone


Publication History

Received: 13 June 2013

Accepted: 04 September 2013

Article published online:
01 May 2022

© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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