One-Stage Reconstruction of the Large Lower Nose Defect Involving 2 Subunits With Lateral Nasal Artery Pedicle Nasolabial Flap.

Abstract

Large nose defect reconstructions involving the tip and alar subunits are still difficult to achieve in one stage. This study aimed to investigate the size of the nasal tip and alae, observe the distribution patterns of the lateral nasal artery and present our clinical experience with the lateral nasal artery pedicle nasolabial (LNAPN) flap. From June 2019 to January 2020, lower nose parameters from 60 subjects were measured by a 3-dimensional scan, and the cranial digital subtraction angiogram results of 20 patents without vascular malformation were retrospectively analyzed. The case series consisted of four patients with nasal tip and alar defects who underwent surgery with LNAPN flaps from December 2018 to June 2019. Outcomes and complications were followed-up at 6 to 12 months. For the 3-dimensional scan study, the mean area of the 2 subunits involving the tip and alae was 7.986 ± 1.728 cm. In the digital subtraction angiogram data, the lateral nasal artery was identified among all facial arteries and had a mean diameter of 1.0 ± 0.20 mm. Sixteen people (80%) had a rich connection between the lateral nasal artery and the transverse facial artery. All cases revealed satisfactory aesthetic outcomes by reconstruction of large defects in one stage. The largest flap of 4.2 cm × 3.0 cm in our study showed complete healing. The LNAPN flap represents a feasible, flexible, efficient, and easily mastered reconstructive method for large nose defects involving the tip and alar subunits.