Important

Description

Nose Reconstruction – Paramedian Forehead Flap

In this nose reconstruction operation a reconstructive surgeon uses skin from the forehead above the eyebrow and pivots it vertically to replace missing nasal tissue.

The goal of nasal reconstruction is to look as normal as possible after reconstruction. The results of nasal reconstruction using the paramedian forehead flap are quite good, although some patients report functional difficulties. Airway passage difficulties, mucosal crusts, dry mucosa, and difficulties with smelling are uncommon. A minority of the patients reported snoring more often or having a spontaneous nose bleed more often. Difficulties with phonation are not likely to occur. The majority of patients are satisfied with function of the nose after reconstruction.

Ideally, standardized semistructered interviews are used to assess aesthetic outcome after nasal reconstruction. Studies using these interviews showed that generally patients are very satisfied with the result although they reported aggravating of their nasal appearance compared to before surgery. Patients were especially satisfied with flap color match and shape of the nasal tip. Remarkably, patients scored subjective aesthetic outcome significantly higher compared to a professional panel.

In comparison to the two stage flap, the three stage flap technique has shown better results, lower revision rates and more possibilities for use of skin grafts for lining. Most likely this is because of the reliable vascularisation of the three stage flap.