“Nasal lining rotation flap with triangular fossa composite graft, an effective method for managing the multiply-revised Asian short nose”

Abstract

Postoperative short nose is one of the most difficult problems encountered in plastic surgery. We propose a technique of lining rotation flaps combined with composite chondrocutaneous auricular graft from the triangular fossa to reconstruct the lining defect and improve surgical results. Twenty patients were operated on between 2016 and 2019 for postoperative short nose. Lining rotation flaps were used to supply missing medial mucosal lining with creation of a raw surface at the lateral lining in 10 patients (intervention group). A total of 17 composite chondrocutaneous grafts taken from the triangular fossa of the ears were used to resurface the defect. The other 10 patients received lining management using conventional techniques (control group). There was a near-complete take of 13/17 composite grafts (76.5%), with four partial losses that healed uneventfully. Anthropometric analysis of preop and postop profile photos showed statistically significant decreased nasolabial angle in both groups. The amount of derotation achieved was significantly increased (p<0.05) with our proposed method (Intervention group: 12.3±9.3° vs. control group: 6.55±4.5°). Donor sites healed uneventfully. Both groups of patients were satisfied with their results based on Rhinoplasty Outcomes Evaluation questionnaire. The lining rotation flap with triangular fossa composite graft is a safe and effective method for management of the postoperative short nose in Asians.