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Nasal Reconstruction: Experience Using Tissue Expansion and Forehead Flap
- Source :
- Journal of Oral and Maxillofacial Surgery. 69:1478-1484
- Publication Year :
- 2011
- Publisher :
- Elsevier BV, 2011.
-
Abstract
- Purpose The forehead is acknowledged to be one of the best, if not the best, donor sites for reconstruction of postoperative nasal defects after ablation in cancer patients. The versatility, color match, and texture are among the benefits of this flap. However, it has 2 major disadvantages: 1) it is stiff, flat, and thicker than normal nasal skin, and thus molding from a 2-dimensional to a 3-dimensional shape is difficult, and 2) there is a donor-site defect that requires coverage using a split-thickness skin graft. Patients and Methods In this 5-year study (2004–2009), we modified the 2-stage technique and added an operation before tissue transfer and pedicle division in 48 patients with nasal defects. During the first stage, the tumor was completely excised, and a tissue expander was inserted in the subgaleal plane. After 3 weeks, expansion was initiated. The second operation was performed 12 weeks later. A full-thickness forehead flap was elevated and transposed with primary closure of the donor site. In a third or final stage 3 weeks later, the pedicle was divided. Patient satisfaction and donor site scar was evaluated. Results Over the past 5 years, 48 reconstructions for nasal defects were performed using this technique. Nasal defects of the dorsum, alar, tip, columella, and septum were successfully treated. Graft take was successful in all patients. Conclusions The forehead flap technique, in conjunction with tissue expander for nasal repair, has both advantages and disadvantages. The esthetic benefits of this technique must be weighed against the disadvantages.
- Subjects :
- Adult
Male
medicine.medical_specialty
Esthetics
medicine.medical_treatment
Nose Neoplasms
Tissue Expansion
Subcutaneous Fat
Facial Muscles
Nose
Surgical Flaps
Cicatrix
Graft take
Cartilage transplantation
Humans
Medicine
Forehead
Aged
Retrospective Studies
Aged, 80 and over
Columella
business.industry
Graft Survival
Tissue Expansion Devices
Skin Transplantation
Middle Aged
Plastic Surgery Procedures
Ablation
Surgery
Cartilage
Treatment Outcome
medicine.anatomical_structure
Otorhinolaryngology
Carcinoma, Basal Cell
Patient Satisfaction
Carcinoma, Squamous Cell
Tissue and Organ Harvesting
Female
Forehead flap
Oral Surgery
business
Tissue expansion
Subjects
Details
- ISSN :
- 02782391
- Volume :
- 69
- Database :
- OpenAIRE
- Journal :
- Journal of Oral and Maxillofacial Surgery
- Accession number :
- edsair.doi.dedup.....db1995f2c6e46bfd723d03bfeac2595e