Nasal alar and lobule reconstruction – Case presentation

Aurelian Radu Budurca 1 , 2 , Teodor Stamate 1 , 2 , Mihail Dan Cobzeanu 1 , 3  and Angelica Balaur 2
  • 1 “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania
  • 2 Plastic and Reconstructive Surgery Department, “Sfantul Spiridon” County Emergency Hospital, Iasi, Romania
  • 3 ENT&HNS Department, “Sfantul Spiridon” County Emergency Hospital, Iasi, Romania

Abstract

We present a reconstruction of a posttraumatic nasal lobular and alar defect in a three-stage intervention. The first operation restored the cartilaginous support by a combination of a free conchal composite graft and a septal chondromucosal pivotal flap covered by a paramedian forehead pedicled flap. The second operation separated the pedicle of the flap, followed one month later by cosmetic refinements. We restored both length and shape of the nose and a functional symmetrical nostril. Surgical options are discussed regarding available donor areas and techniques.

Conclusion. Lobule reconstruction must be performed as an entire esthetic unit and must address all three layers - skin, cartilage and internal lining. Careful planning is fundamental in ensuring good cosmetic results.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Menick F.J. - Nasal Reconstruction - Art and practice. Mosby. Elsevier. 2009 ;pp.109 - 238.

  • 2. Darsonval V., Arnaud D., Duron J.-B., Bardot J.. Rousseau P. - Reconstruction de pleine épaisseur de la pyramide nasale. Ann.Chir. Plast.Esthét., 2013;58:544-600.

  • 3. Constantine F.C., Crosby M.A. - Nasal Reconstruction. In: Janis J.E. ed. - Essentials of Plastic Surgery 2nd Ed, CRC Press., Boca Raton., 2014 ;pp.403-419.

  • 4. Menick F.J., Salibian A. - Primary intranasal lining injury cause, deformities, and treatment plan. Plast.Reconstr.Surg., 2014;134(5):1045-1056.

  • 5. Ceratti T.A., Casado Neto A.S., Vittorazzi A., Barros M.E., Farina J.A. Jr. - Use of a composite auricular graft in nasal alar reconstruction. Rev Bras Cir Plást., 2012;27(4):640-643.

  • 6. Burget G.C., Walton R.L. - Reconstruction esthétique totale du nez et des unités faciales adjacentes par combinaison optimisée lambeaux libres, greffes cartilagineuses et lambeau pédiculé frontal paramédian. Ann. Chir.Plast.Esthét., 2009;54:497-522.

  • 7. Talmant J.C. - Reconstruction du nez. Encycl.Méd.Chir (Elsevier, Paris), Techniques chirurgicales - Chirurgie plastique reconstructrice et esthétique, 45-540, 1999, 31 p.

  • 8. Dobratz E.J., Hilger P.A. - Techniques of columellar and alar nasal reconstruction. Operative Techniques in Otolaryngology, 2011;22:59-64.

  • 9. Menick F.J. - Aesthetic nasal reconstruction. In: Neligan P.C. ed. - Plastic Surgery, 3rd Ed., Elsevier. London., 2013, vol.3., Chapter 6.

  • 10. Zhenmin Z., Senkai L., Yiping, Y., Yangqun M.D., Mingyong Y., et.al. - The Septal Chondromucosal Island Pedicle Flap: Anatomic Study and Clinical Application. Plast.Reconstr. Surg., 1999;103(5):1355-1360.

OPEN ACCESS

Journal + Issues

Search