Single-stage forehead flap in nasal reconstruction
Department of Surgery, Division of Plastic Surgery
Adolescent; Adult; Aged; Aged, 80 and over; Child; Ear Cartilage; Female; Forehead; Humans; Male; Middle Aged; Nose Neoplasms; Retrospective Studies; Rhinophyma; Rhinoplasty; *Surgical Flaps; Treatment Outcome; Xeroderma Pigmentosum
Life Sciences | Medicine and Health Sciences
The paramedian forehead flap has become the standard of care for major nasal reconstruction. The classic procedure involves a second-stage operation to divide and inset the external pedicle. We present our experience in a clinical series using single-stage forehead flap reconstruction. Our indications include elderly patients, pediatric patients treated during mission trips, and any patient in whom an external pedicle or two-stage procedure is problematic. From 2008 to 2009, 9 patients underwent a single-stage forehead flap. The majority had defects after excision of skin cancer. Our modification involves removal of radix and proximal nasal skin and fat and deepithelialization of the proximal pedicle to allow inset without excess compression or kinking. This modification avoids the sequelae of an external pedicle, which include bleeding, dressings, the inability to wear eyeglasses, and the patient's reluctance to appear in public. It safely provides acceptable results and avoids a mandatory secondary procedure.
DOI of Published Version
Ann Plast Surg. 2010 May;64(5):645-8. Link to article on publisher's site
Annals of plastic surgery
Fudem, Gary M.; Montilla, Richard D.; and Vaughn, Carolyn J., "Single-stage forehead flap in nasal reconstruction" (2010). University of Massachusetts Medical School. Senior Scholars Program. Paper 142.