Interpolation Flaps for Nasal Reconstruction

Abstract

Objective: Determine whether the type (paramedian forehead [PMFF] vs nasolabial [NLF]) or the defect thickness (full vs partial) play a role in take rates of interpolation flaps in nasal reconstruction. Method: A retrospective chart review was performed on patients who underwent nasal reconstruction with 2-stage paramedian forehead or nasolabial flaps between 2002 and present. Defect characteristics recorded were thickness, size, location; flap type used for repair, utilization of cartilage grafts; and comorbidities, including diabetes, peripheral vascular or coronary artery disease, and smoking habits. Results: A total of 107 total patients; 82 (76%) reconstructed using 2-stage paramedian forehead flap; 25 (24%) using a 2-stage nasolabial flap (NLF). A total of 47 PMFF and 12 NLF were used for full thickness defects. Overall failure rate was 5%, both partial and complete. Five PMFF failed (7%), 3 full thickness. One NLF failed (4%), also full thickness. Any use of cartilage in reconstruction did not affect failure rates. Both flaps with complete failure were used more distally, while partial failure flaps for more proximal defects. No comorbities were noted to have a significant effect on failure rates, 5 out of 6 failures were in smokers. Conclusion: This study provides outcome data when interpolation flap reconstruction, with or without cartilage grafts, is offered. Overall success rates for nasal reconstruction using interpolation flaps in this study were 94%. Thickness of defect and type of flap did not affect outcome, while positive smoking status did significantly affect failure rate.