Joshua E Lane1,2,3,4, Ling-Lun Bob Hsia5, Bradley G Merritt6. 1. Department of Surgery, Mercer University School of Medicine, Macon, Georgia. 2. Division of Dermatology, Department of Internal Medicine, Mercer University School of Medicine, Macon, Georgia. 3. Division of Dermatology, Department of Medicine, The Medical College of Georgia, Augusta, Georgia. 4. Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia. 5. Department of Dermatology and Dermnatologic Surgery, Medical University of South Carolina, Charleston, South Carolina. 6. Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina.
Abstract
BACKGROUND: Reconstruction of large nasal surgical defects often warrant the use of mucosal flaps to repair the inner lining. This often presents a challenge for surgical reconstruction. OBJECTIVE: To describe a unique reconstructive option for the repair of large surgical wounds that necessitate mucosal nasal lining. MATERIALS AND METHODS: This study is a retrospective review of 10 patients who underwent surgical reconstruction of large nasal and/or heminasal surgical defects following Mohs micrographic surgery. A nasolabial turnover interpolation flap was used to repair missing nasal mucosal lining, coupled with a cutaneous flap which typically involved a paramedian forehead flap. The duration of follow-up was 8 months. An aesthetic and functional surgical outcomes measure was used to assess the final repair. RESULTS: Favorable aesthetic outcomes were obtained in all patients and without need of revision surgery by the use of a nasolabial turnover interpolation flap. CONCLUSION: The nasolabial turnover interpolation flap offers a reliable and effective method of repair for large transmural nasal surgical wounds. We typically paired this nasal lining flap with a paramedian forehead flap with reliable and aesthetic outcomes. This technique is straightforward, reproducible, and with both good aesthetic and functional outcomes.
BACKGROUND: Reconstruction of large nasal surgical defects often warrant the use of mucosal flaps to repair the inner lining. This often presents a challenge for surgical reconstruction. OBJECTIVE: To describe a unique reconstructive option for the repair of large surgical wounds that necessitate mucosal nasal lining. MATERIALS AND METHODS: This study is a retrospective review of 10 patients who underwent surgical reconstruction of large nasal and/or heminasal surgical defects following Mohs micrographic surgery. A nasolabial turnover interpolation flap was used to repair missing nasal mucosal lining, coupled with a cutaneous flap which typically involved a paramedian forehead flap. The duration of follow-up was 8 months. An aesthetic and functional surgical outcomes measure was used to assess the final repair. RESULTS: Favorable aesthetic outcomes were obtained in all patients and without need of revision surgery by the use of a nasolabial turnover interpolation flap. CONCLUSION: The nasolabial turnover interpolation flap offers a reliable and effective method of repair for large transmural nasal surgical wounds. We typically paired this nasal lining flap with a paramedian forehead flap with reliable and aesthetic outcomes. This technique is straightforward, reproducible, and with both good aesthetic and functional outcomes.