Partial Nasal Defects Research Articles

Fabrication of a silicone partial nasal prosthesis

Fabricating a partial extraoral prosthesis is challenging, especially partial nasal prosthesis. An extraoral prosthesis can be successful when patients can socialize without fear of being noticed with an abnormal facial defect. Homogeneity, subtle textures, and color match are essential to fabricate successful extraoral prosthesis. In this case report, a 69-year-old Caucasian female patient presented with a partial nasal defect. A silicone partial nasal prosthesis was fabricated to replicate the missing structures.

Repairing partial nasal defect with different strategies

Objective Proper selection of reconstruction method is the key point to get a successful result in nasal reconstruction. The purpose of the article is to evaluate the results of repairing the partial nasal defect with different surgical strategies. Methods Different surgical methods were used according to the area and type of nasal defects of nasal defects, the different sub-unit of nasal defects and the different tissue damage levels. Local skin flaps, auricular composite tissue flaps, nasolabial skin flaps and superficial temporal artery pedicle flaps were used in these patients. Results 23 cases suffering from partial nasal defects were repaired with flaps or tissue graft, including 4 auricular composite tissue flap, 5 nasolabial skin flap, 3 forehead island flap with a pedicle of superficial temporal vessels, 7 local flap, and 1 skin graft. After 5-16 months of follow-up, the color and texture around the nose were basically consistent, the appearance of nose was satisfactory, and the postoperative effect turned out fine. Conclusions The method of surgical reconstruction of partial nasal defects should be considered carefully according to the area of nasal defects, sub-unit of nasal defects and the different tissue damage levels. Key words: Nasal defect; Reconstruction; Flap

Long-Term Results of Partial Nasal Reconstructions with Indian Flap.

The aim of the study was clinical evaluation of the results following reconstruction with the Indian flap in patients with partial nasal defects, and estimation of their postoperative life quality in functional and aesthetic aspects. We analyzed results in 38 patients who underwent reconstructions with the Indian flap in the Department of Plastic, Reconstructive and Aesthetic Surgery between years 2000‑2013. The patients were followed-up for at least 2 years. We estimated their life quality in aesthetic and functional aspects after surgery. Observed complications of nasal reconstruction were alar asymmetry in 6 patients (15.8%), nasal obstruction in 6 persons (15.8%), wide postoperative scar in 4 (10.5%), and non-aesthetic appearance of the donor site in two cases (5.3%). Estimation of life quality post surgery in the examined group of patients revealed significant postoperative improvement in both functional and aesthetic aspects. 1. Reconstructions of nasal defects with the Indian flap resulted in satisfactory longterm postoperative results, which confirms the efficiency of the applied technique. 2. Reconstructive surgery with Indian flap of individuals with partial nasal defects contributed to significant postoperative improvement in both functional and aesthetic aspects and their life quality.

Resurfacing Partial Nose Defects With a Retroauricular Skin/Cartilage Free Flap

The retroauricular skin has always received much attention by plastic surgeons for use in nose reconstruction because of its rich vascularity. Anatomically, the skin of this area lies hidden behind the ear and is very similar to that of the face. More importantly, the retroauricular skin flap along with the cartilage can be used to repair defective cartilage of the nose. All these reasons make this area an ideal donor site for nose reconstruction. This article presents the surgical procedures for reconstruction of partial nasal defects with the use of retroauricular skin/cartilage free flaps. Based on the anatomy and blood supply of the retroauricular region, a flap was designed and harvested with the retroauricular vessels as its pedicle. This flap was used to repair the partial nose defects in 10 patients, between the years 2002 and 2008. Of these, 4 patients presented with unilateral ala defects; 2 with nasal tip defects; 2 with defects on the nasal tip and bilateral ala; 1 with unilateral ala and tip defect; and 1 with unilateral ala and lateral defect. The size of the defect ranged from 2.5 × 1.5 cm to 4.0 × 3.0 cm. The flap varied between 3.0 × 2.0 cm and 4.5 × 3.5 cm. In all cases, the auricular cartilage of 1.5 × 1.0 cm to 1.0 × 0.5 cm was taken along with the flap. The retroauricular vessels were anastomosed with the facial vessels. The donor site was covered with full-thickness skin graft or local flap. No flap failure was recorded. Excellent morphologic reconstruction was obtained with these flaps with no sequela at the donor site in terms of form and function. Postoperatively, the blood supply to the flaps was fairly good in 8 cases, although there was vein congestion in 2 cases on the fourth day. However, the postoperative results of the 10 cases were satisfactory after treatment. The retroauricular skin-cartilage free flap is a good choice for partial nasal reconstruction, having the merits of a well-hidden donor site, good color match, and 1-stage operation for cartilage support and nose reconstruction.

Definitive magnetic nasal prosthesis for partial nasal defect

Maxillofacial trauma refers to any injury to the face or jaw caused by physical force, trauma, the presence of foreign objects, animal or human bites, and burns. Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potential compromises in quality of life. Restoration of facial defects, especially nasal defects, is a difficult challenge for both the surgeon and the prosthodontist. Here is a case report of partial nasal defect caused by trauma, rehabilitated with a magnetic nasal prosthesis made with silicone elastomers using mechanical and anatomical retentive aids.

Healing of composite chondrocutaneous auricular grafts covered by skin flaps in nasal reconstructive surgery.

Healing of composite chondrocutaneous auricular grafts combined with overlying skin flaps for reconstruction of the internal lining in partial nasal defects should be evaluated. A retrospective chart review and prospective clinical follow-up of 15 patients with partial nasal defects. Fifteen patients with partial defects of the middle and lower third of the nose were reviewed. Nineteen composite ear grafts were used for reconstruction of the internal nasal lining in the patient group. The composite grafts were used in combination with overlying nasolabial transposition flaps. In some patients paramedian forehead or turn-in flaps were needed as well. Functional and aesthetic results of nasal reconstruction were subjectively graded by the patients and medical doctors of the department. Three of 19 transplanted composite grafts showed postoperative deformation. Relative shrinkage was observed in 5 of 19 composite grafts, whereas complete loss of the composite graft was seen in only one patient. Nasal airway obstruction was observed in the patients with deformity or loss of composite graft (4 of 15 patients), and an unsuccessful aesthetic result was seen only in the patient with total composite graft failure (1 of 19 transplanted grafts). Composite ear grafts may provide good functional and aesthetic results when combined with overlying skin flaps in reconstruction of partial nasal defects. Even though composite ear grafts used for restoration of the inner nasal lining may be deformed or absorbed and impairment of nasal airway patency or aesthetic result may be postoperatively observed, the combination of composite ear grafts with locoregional transposition flaps provides additional reconstructive options for selected nasal defects.

Nasal reconstruction using a combination of alloplastic materials and autogenous tissues: a surgical alternative.

Re-creation of a functional and aesthetically acceptable nose after partial nasal defect requires accurate reproduction of nasal lining, support, and coverage. Most authors recommend an approach to reconstruction with cantilevered bone grafting and paramedian forehead flap placement. The authors propose an alternative approach for selected patients with total or near-total nasal defects combining both alloplastic and autogenous tissues. This method uses vitallium or titanium mesh for the dorsal framework formation, tissue-expanded paramedian forehead flap for soft tissue coverage, and composite chondrocutaneous auricular grafts for tip reconstruction. Nine individuals underwent nasal reconstruction using this method. The indications, details, and potential advantages of this technique are described with accompanying photographic results. A flexible approach using a combination of alloplastic materials and autogenous tissues provides additional reconstructive options for individuals with total or near-total nasal defects.

Composite grafts in nasal surgery.

RHINOPLASTY surgery consists of hump removal, shortening and narrowing of the nose, and, in some instances, the insertion of grafts and implants. It is generally agreed that autogenous bone and cartilage are the best materials for grafting; silicone in solid or liquid form is still under investigation as an implant material and looks promising. With the passage of time it became apparent that some unoperated upon noses would benefit by being lengthened and that techniques had to be developed to handle satisfactorily secondary operations, alar collapse, posttraumatic cicatrization, and the reconstruction of partial nasal defects. Such cases generally appear with missing bony and cartilagenous elements, scar-tissue contracture, and insufficient outer (skin) or inner (mucous membrane) lining. Simple scar excision and soft-tissue replacement is unsatisfactory because of the tendency of skin and mucous membrane to shrink after transplantation and, besides, scar-tissue removal leads to new scar formation. To counteract these eventualities,