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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2002 August;13(2):93-100
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
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.