BACKGROUND: Reconstruction of isolated nasal lining defects can be extraordinarily daunting. This report defines the uniqueness of the surgical challenges inherent to reconstruction of the nasal lining and overviews the authors' approach to management. METHODS: A retrospective review was performed of 11 consecutive patients presenting for reconstruction of the nasal lining alone during the period from October of 1996 through March of 2003. There were four men and seven women with an average age of 49.2 years. The average follow-up was 4.2 years. RESULTS: Five patients required reconstruction of the total nasal lining (floor, columella, vestibule), and the remaining reconstructions involved subtotal components. Coincidental necrosis of the nasal lining during total/subtotal nasal reconstruction was the most common cause. A single microsurgical free flap was used in eight patients (six radial forearm flaps). Three patients required two free flaps. There were no flap failures. Thirteen of 14 free flaps healed primarily. Dehiscence of the flap/nasal septal juncture occurred in one cocaine-injured nose. Ten of 11 patients demonstrated patent, functional nasal airways postoperatively. CONCLUSIONS: Reconstruction of the nasal lining, alone, is a very challenging endeavor that demands careful surgical planning and precise technical execution. The use of microsurgical transfer for these defects allows considerable latitude for duplication of the missing complex three-dimensional anatomy and avoids sullying the adjacent facial soft tissues. Because of the adverse condition of the local tissues, the majority of these cases could not have been brought to a successful conclusion without the use of free tissue transfer, and this is particularly relevant in the cocaine-injured nose.
BACKGROUND: Reconstruction of isolated nasal lining defects can be extraordinarily daunting. This report defines the uniqueness of the surgical challenges inherent to reconstruction of the nasal lining and overviews the authors' approach to management. METHODS: A retrospective review was performed of 11 consecutive patients presenting for reconstruction of the nasal lining alone during the period from October of 1996 through March of 2003. There were four men and seven women with an average age of 49.2 years. The average follow-up was 4.2 years. RESULTS: Five patients required reconstruction of the total nasal lining (floor, columella, vestibule), and the remaining reconstructions involved subtotal components. Coincidental necrosis of the nasal lining during total/subtotal nasal reconstruction was the most common cause. A single microsurgical free flap was used in eight patients (six radial forearm flaps). Three patients required two free flaps. There were no flap failures. Thirteen of 14 free flaps healed primarily. Dehiscence of the flap/nasal septal juncture occurred in one cocaine-injured nose. Ten of 11 patients demonstrated patent, functional nasal airways postoperatively. CONCLUSIONS: Reconstruction of the nasal lining, alone, is a very challenging endeavor that demands careful surgical planning and precise technical execution. The use of microsurgical transfer for these defects allows considerable latitude for duplication of the missing complex three-dimensional anatomy and avoids sullying the adjacent facial soft tissues. Because of the adverse condition of the local tissues, the majority of these cases could not have been brought to a successful conclusion without the use of free tissue transfer, and this is particularly relevant in the cocaine-injured nose.
Authors: Letizia Nitro; Carlotta Pipolo; Gian Luca Fadda; Giovanni Felisati; Alberto Maria Saibene; Fabiana Allevi; Mario Borgione; Giovanni Cavallo Journal: Eur Arch Otorhinolaryngol Date: 2022-02-09 Impact factor: 3.236
Authors: Rami S Kantar; William J Rifkin; Michael J Cammarata; Adam Jacoby; Scott J Farber; J Rodrigo Diaz-Siso; Daniel J Ceradini; Eduardo D Rodriguez Journal: Plast Reconstr Surg Glob Open Date: 2018-09-05