Forehead versus nasolabial flaps for alar subunit reconstruction

Abstract

Background: The reconstruction of full-thickness alar wounds often requires multiple challenging surgical procedures. These procedures, although often functionally and aesthetically successful, are often staged, and they therefore introduce operative risks, significant investments of surgeon and patient time, and extraordinary costs. Aim of the work: Evaluation of the aesthetic and functional outcome, complications and donor site morbidity after alar reconstruction by paramedian forehead flap, two stage nasolabial flap and one stage nasolabial flap. Patients & methods: This research discusses the outcome of (27) patients after alar reconstruction: (11) patients with paramedian forehead flap, (9) patients with two stage nasolabial flap and (7) patients with one stage nasolabial flap. Conchal cartilage is used for reconstruction of the cartilagenous part of the alar subunit. Results: Better results occur with nasolabial flap with best results with the one stage technique as regard the functional and aesthetic results and donor site morbidity. Conclusion: More favourable aesthetic and functional results for alar subunit reconstruction occurred with the one stage nasolabial flap technique but when there is an associated other nasal subunit injuries, paramedian forehead flap and two stage nasolabial flap still have the best option.