Application of four kinds of local perforator flaps in reconstruction of nasal wing defects

Abstract

Objective This paper introduces four surgical methods and effects of one-stage repair for defect in nasal wing because of tumor resection and other reasons. Methods Totally 41 cases of nasal wing defects caused by various reasons admitted to the First Affiliated Hospital of Anhui Medical University from June 2015 to June 2018 were analyzed retrospectively, including 22 male patients and 19 female patients, age ranged from 15 to 93 years, with an average of 45 years. All patients were treated and repaired with the nasolabial horn-shaped perforated pedicle flaps(20 cases), the lateral nasal artery horn-shaped perforated pedicle flaps(10 cases), the nasolabial sulcus island flaps based on nasal basal perforator vessel(6 cases) and the supralabial-nasolabial horn-shaped perforated pedicle flaps(5 cases). Results All the flaps that were used in 41 patients were transplanted successfully, size ranged from 0.5 cm×1.5 cm-4.0 cm×4.0 cm. The defects on the nasal wing were completely repaired, and the wounds healed in one stage. All patients underwent postoperative follow-up for a period of 4 months to 1 year. Postoperative results indicate that the patients’ alae shapes of the nose were good, the functions were not significantly affected, and no recurrences were found in the cancer cases. Conclusions The nasolabial horn-shaped perforated pedicle flap can be used for lager defects of the the nasal wing, and the lateral nasal artery horn-shaped perforated pedicle flap can be used for the minor defects. In addition, the nasolabial sulcus island flap based on nasal basal perforator vessel can be used when the facial skin tension is greater. Finally, the supralabial-nasolabial horn-shaped perforated pedicle flap is suitable when the defect is near the nasolabial sulcus. All patients can obtain better aesthetic results when the flap is selected according to the actual situation and reasonably. Key words: Nose deformities, acquired; Nose neoplasms; Surgical flaps; Perforator flap; Horn-shaped perforated pedicle flap; Defect of nasal ala