Nasal Tip Reconstruction with Nasal Dorsum Flap in Elder Patients

Abstract

Background: Basal cell carcinomas are often found on the nose, especially on the nasal tip. To reconstruct the defect on the nasal tip after cancer ablation is still a challenge because of the unique color, thickness and texture of the nasal tip. Aim and Objectives: A rectangular nasal dorsum flap was designed based on pedicles from both side of the supratrochlear artery (via ophthalmic artery) to cover the nasal tip defect in single-stage operation, which can provide an alternative to a good esthetic result in reconstruction of nasal tip defect. Material and Method: From October 1997 to February 2004, three elder patients with nasal tip defect after basal cell carcinoma excision was comet to our outpatient department. These defects were reconstructed with nasal dorsum flap. The largest defect was 2.0×2.5 cm and the average size of the defect was 2.0×1.78cm. From anatomical viewpoint, the nasal dorsum flap has a good axial blood flow and reliable regional superior orbital plexus blood supply. Result: All three patients had undergone defect reconstruction with nasal dorsum flap. There is no partial necrosis or total loss of flap, and no donor site morbidity. All patients had good aesthetic results without any nasal tip distortion with 12-24 months follow-up, respectively. This flap is an easy, reliable, and excellent alternative for nasal tip defect, especially for elder patients. Conclusion: The nasal dorsum flap has reliable glabellar collateral blood supply and is easy in design for a dissection. This flap can be used for reconstruction of medium to large size of nasal tip defect with tissue-like tissue to reconstruct tissue and has excellent result with negligible morbidity. We found that the elder patients with some creases and laxity skin over glabellar area have a good cosmetic result without any over undermining flap and excising the Burow's triangles. These patients with large to medium size of nasal tip defects have well long-term cosmetic results of reconstructive with nasal dorsum flap.