Split Dorsal Nasal Flap: A Modification to Expand Its Utilization

Abstract

Nasal reconstruction presents the facial plastic surgeon with a complex problem given its functional and aesthetic importance. The dorsal nasal flap is a composite rotational flap of the glabella and nasal dorsum that can be used for nasal dorsum and tip defects of medium to large sizes. Given its composite nature, this flap can be split into its constituent parts—the epidermis and dermis and the subcutaneous tissue and superficial musculoaponeurotic system—without flap loss. This case series describes this technique and various potential applications within nasal reconstruction.

Keywords

nasal reconstruction - rotational flap - nasal tip defect - nasal dorsum

Publikationsverlauf

Accepted Manuscript online:
21. August 2024

Artikel online veröffentlicht:
12. September 2024

• References

• 1 Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg 1985; 76 (02) 239-247
• 2 Iorio CB, Christophel JJ, Park SS. Nasal reconstruction: defects that cross anatomical subunits. Facial Plast Surg 2020; 36 (01) 91-101
• 3 Veldhuizen IJ, Budo J, Kallen EJJ. et al. A systematic review and overview of flap reconstructive techniques for nasal skin defects. Facial Plast Surg Aesthet Med 2021; 23 (06) 476-481
• 4 Menick FJ. Nasal reconstruction. Plast Reconstr Surg 2010; 125 (04) 138e-150e
• 5 Papadopoulos O, Kostopoulos E, Karypidis D, Tsantoulas Z, Moustaki M. Review of nasal reconstruction. J Craniofac Surg 2009; 20 (04) 1072-1077
• 6 Park SS. Nasal reconstruction in the 21st century–a contemporary review. Clin Exp Otorhinolaryngol 2008; 1 (01) 1-9
• 7 Paddack AC, Frank RW, Spencer HJ, Key JM, Vural E. Outcomes of paramedian forehead and nasolabial interpolation flaps in nasal reconstruction. Arch Otolaryngol Head Neck Surg 2012; 138 (04) 367-371
• 8 Little SC, Hughley BB, Park SS. Complications with forehead flaps in nasal reconstruction. Laryngoscope 2009; 119 (06) 1093-1099
• 9 Gillies HD. Plastic Surgery of The Face. Oxford: Oxford Medical Publishers; 1920
• 10 Rieger RA. A local flap for repair of the nasal tip. Plast Reconstr Surg 1967; 40 (02) 147-149
• 11 Eren E, Beden V. Beyond Rieger's original indication; the dorsal nasal flap revisited. J Craniomaxillofac Surg 2014; 42 (05) 412-416
• 12 Johnson TM, Swanson NA, Baker SR, Brown MD, Nelson BR. The Rieger flap for nasal reconstruction. Arch Otolaryngol Head Neck Surg 1995; 121 (06) 634-637
• 13 Redondo P, Bernad I, Moreno E, Ivars M. Elongated dorsal nasal flap to reconstruct large defects of the nose. Dermatol Surg 2017; 43 (08) 1036-1041
• 14 Rohrich RJ, Muzaffar AR, Adams Jr WP, Hollier LH. The aesthetic unit dorsal nasal flap: rationale for avoiding a glabellar incision. Plast Reconstr Surg 1999; 104 (05) 1289-1294
• 15 Raschke GF, Rieger UM, Bader RD, Kirschbaum M, Eckardt N, Schultze-Mosgau S. Evaluation of nasal reconstruction procedures results. J Craniomaxillofac Surg 2012; 40 (08) 743-749
• 16 Losquadro WD, Bared A, Toriumi DM. Correction of the retracted alar base. Facial Plast Surg 2012; 28 (02) 218-224
• 17 Alexander AJ, Shah AR, Constantinides MS. Alar retraction: etiology, treatment, and prevention. JAMA Facial Plast Surg 2013; 15 (04) 268-274
• 18 Hallock GG. Further clarification of the nomenclature for compound flaps. Plast Reconstr Surg 2006; 117 (07) 151e-160e