Advantages and Disadvantages of Reconstruction of the Nostrial Ala by Composite Graft Apropos of a Case

Abstract

Introduction: The authors report a case of nasal reconstruction by frontal flap and compound graft on an amputation of the nostril. The aim of the work is to determine the advantages and disadvantages of forehead flap with compound graft in nasal reconstruction. Observation: A 30-year-old patient with no particular history was admitted to the stomatology and maxillofacial surgery department of the University Hospital of OWENDO for amputation of the left nostril by human bite. The examination revealed a loss of cutaneous-musculo-cartilo-mucous substance of the nasal ala and part of the tip of the nose. The indication for reconstruction by frontal flap associated with a compound graft was established. The 1st operation allowed a repair combining a septal mucosal graft with the auricular cartilage and the frontal flap. The 2nd stage was performed on D26 and consisted of weaning and repositioning of the frontal flap, completed by degreasing at the level of the nasal wing. Result deemed satisfactory. Discussion: The use of the frontal flap is classically done in 3 stages with defatting in the 2nd stage and can be coupled with a compound graft. This use can also be done in 2 stages with degreasing and late weaning in the 2nd stage with or without a compound graft. One of the advantages remains the good reliability, and one of the disadvantages the frontal scar. Conclusion: The combination of frontal flap and composite graft allows good reconstruction of the nasal ala.