Nasal reconstruction with composite axial paramedian forehead flap – case report

Abstract

Background. Post-traumatic, acute or secondary nasal reconstruction or after tumor ablation involves various techniques that use local, loco-regional or distant flaps, transpozitioned or freely transferred. The reconstruction can be performed at the same time in the case of acute trauma of the nasal pyramid or secondary, at a later time if the local and general situation of the patient requires this. The median frontal flap, simple or composite, ensures a good quality reconstruction of all the aesthetic subunits of the nasal pyramid. The versatility of the flap and the aesthetic quality of the reconstruction result make the median frontal flap a choice solution for nasal pyramid reconstructions where local flaps are not indicated. The reconstruction can be done in two steps or in one step if the pedicle flap is subcutaneous. Case report. The article presents a case of total reconstruction of the nasal lobe after a complex dog bite trauma in which a composite median frontal flap, doubled with auricular cartilage, was used to restore the alar and columella cartilages. Conclusion. The axial paramedian forehead flap is a valuable technique in nasal reconstruction, offering favorable aesthetic outcomes when performed by skilled surgeons.

Keywords

• nasal reconstruction
• axial paramedian forehead flap
• composite forehead flap