Forehead Flap: Master Techniques in Otolaryngology–Head and Neck Surgery

Abstract

When the nose is missing, most patients would like to have their normal appearance and function restored. Unfortunately, the wound does not reflect the true tissue loss and the available donor tissues are not similar to nasal tissues. So subunit principles are applied and donor tissues modified to achieve a satisfactory result. All major reconstructions will require a late revision to revise scars, improve asymmetry, or open the airway. However, when cover and lining are grossly deficient, the repair must be totally redone with a second regional flap. Success requires a thoughtful preoperative analysis and careful reconstructive plan. Small nasal defects may be resurfaced in two stages with a forehead flap but large deep defects are best repaired in three stages with an intermediate operation which allows the placement of primary and delayed primary cartilage grafts, soft tissue sculpting, and folded flap lining replacements with safety.

Keywords

nasal reconstruction - forehead flap - lining flap - primary and delayed primary cartilage grafts - revision

• References

• 1 Menick FJ. Nasal Reconstruction: Art and Practice. Philadelphia, PA: Saunders-Elsevier; 2008
• 2 Menick FJ. Nasal reconstruction: forehead flap. Plast Reconstr Surg 2004; 113: 100e-111e
• 3 Menick FJ. Nasal reconstruction. Plast Reconstr Surg 2010; 125 (4) 138e-150e
• 4 Menick FJ. A new modified method for nasal lining: the Menick technique for folded lining. J Surg Oncol 2006; 94 (6) 509-514
• 5 Menick FJ. An approach to the late revision of a failed nasal reconstruction. Plast Reconstr Surg 2012; 129 (1) 92e-103e