A 10-year experience in microsurgical reconstruction of the nose with a lower extremity flap.

Autor: Yen CI; Department of Plastic and Reconstructive Surgery, Aesthetic Medical Center of Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Lu YJ; Department of Plastic and Reconstructive Surgery, Aesthetic Medical Center of Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Kao HK; Department of Plastic and Reconstructive Surgery, Aesthetic Medical Center of Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Huang JJ; Department of Plastic and Reconstructive Surgery, Aesthetic Medical Center of Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Wu CW; Vendome Private Practice Aesthetic Medical Center, Taipei, Taiwan., Chang CS; Department of Plastic and Reconstructive Surgery, Aesthetic Medical Center of Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Chen HC; Department of Plastic and Reconstructive Surgery, Aesthetic Medical Center of Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Hsiao YC; Department of Plastic and Reconstructive Surgery, Aesthetic Medical Center of Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: b8301063@gmail.com.
Jazyk: angličtina
Zdroj: Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2023 Oct; Vol. 85, pp. 10-17. Date of Electronic Publication: 2023 Jun 15.
DOI: 10.1016/j.bjps.2023.06.039
Abstrakt: Background: Traditionally, radial forearm free flaps are utilized for nasal lining reconstruction when local flaps cannot provide adequate coverage. However, according to our clinical observation, the skin of the forearm flap is relatively thin and prone to collapse. We present a series of nasal reconstructions using free flaps harvested from the lower extremities to determine if the thick flap could provide more support and decrease the tendency of airway collapse.
Methods: From March 2011 to July 2021, we identified 15 patients who underwent total or subtotal nasal reconstruction with free flap from the lower extremities (10 anterolateral thigh flap, 4 medial sural artery perforator flap, and 1 profunda artery perforator flap). We included 15 patients who underwent free forearm flap reconstruction as controls. The Nasal Obstruction Symptoms Evaluation (NOSE) score was utilized to subjectively evaluate the degree of nasal obstruction symptoms.
Results: The lower extremity group had a lower NOSE score than the forearm group (25.4 vs. 40). It took more time (6.5 vs. 4.2 months) and more surgeries (4.6 vs. 2.6) from the first free flap reconstruction till forehead flap reconstruction in the lower extremity group than in the forearm group, although the total number of surgeries was comparable between the 2 groups (7.2 vs. 8.1).
Conclusions: Utilizing free flaps from the lower extremities in total or subtotal reconstruction of the nasal lining may decrease the tendency of flap collapse and alleviate airway obstruction symptoms and may also allow reconstruction of surrounding defects simultaneously compared with using forearm flaps.
Competing Interests: Conflict of Interest None.
(Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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