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Rivista Italiana di Chirurgia Maxillo-Facciale 2002 August;13(2):93-100

language: English

Nasal pyramid reconstruction by means of forehead flaps with respect for esthetic subunits

Campobassi A. 1, Bassi M. 1, Hassanipour A. 1, Marchetti C. 2

1 Department of Maxillo-Facial Surgery Maurizio Bufalini Hospital, Cesena
2 Maxillo-Facial Surgery University of Bologna, Bologna


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Background. A meth­od of ­nasal recon­struc­tion empha­siz­ing ­the ­use of ­thin ­but high­ly vas­cu­lar ­local lin­ing ­and cov­er ­flaps to ­allow suc­cess­ful pri­mary place­ment of del­i­cate car­til­age ­grafts is pre­sent­ed. The car­til­age fab­ri­ca­tion pro­vides pro­jec­tion in ­space, air­way paten­cy ­and, ­when vis­ible ­through con­form­ing ­skin cov­er, ­the del­i­cate con­tour of ­the nor­mal ­nose. Because tis­sue is ­replaced in ­kind ­and quan­tity, ­the ­need ­for mul­ti­ple revi­sions to ­sculpt ­and ­debulk is ­decreased. Anyway, ­the objec­tive ­was to iden­ti­fy refine­ments in fore­head ­flap ­nasal recon­struc­tion ­that con­sis­tent­ly pro­vide bet­ter esthet­ic ­and func­tion­al ­results.
Methods. Case ­series of ­patients affect­ed by dif­fer­ent ­nasal dis­eas­es ­were under­go­ing par­a­me­dian fron­tal ­flap ­nasal recon­struc­tion. During ­the ­study ­and treat­ment ­from June 9, 2000, to May 10, 2001, 7 ­patients under­went fore­head ­flap, lin­ing replace­ment, car­ti­lag­i­nous recon­struc­tion in ­the Department of Maxillofacial Surgery at ­the M. Bufalini Hospital (Cesena, Italy). Esthetic ­and func­tion­al ­results of ­nasal recon­struc­tion ­were sub­jec­tive­ly grad­ed by ­our ­equipe ­and ­the ­patients.
Results. With ­this recon­struc­tive tech­nique, a ­nice improve­ment of esthet­ic ­and func­tion­al recov­ery ­was ­obtained. The ­most com­mon ­nasal sub­units recon­struct­ed ­were: ­ala, side­wall, dor­sum, ­and ­tip. The esthet­ic ­results ­ranged ­from aver­age to excel­lent, ­the func­tion­al ­results ­ranged ­from ­improved to ­much ­improved ­over pre­op­er­a­tive breath­ing.
Conclusions. The pre­dict­abil­ity of ­the tech­niques in pro­vid­ing excel­lent ­results in ­patients under­go­ing ­nasal recon­struc­tion decreas­es ­the ­need ­for revi­sion pro­ce­dures ­and ­helps ­the ­patient ­and ­the sur­geon ­achieve ­the ­desired out­come.

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