An Strategy of Integrative Reconstructing Nasal and Upper Lip Defect Using an Extended Forehead Flap
Shuangbai Zhou, M.D., Ph.D., Feng Xie, M.D., Ph.D.Ph.D., Bowen Gao, M.D., Ph.D., Qing-Feng Li, M.D., Ph.D..
Shanghai Jiao Tong University, Shanghai Ninth People's Hospital, Shanghai, China.
PURPOSE: Nose and mouse as their central location on face is very important to reconstruction. The reconstruction of mid-lower face should consider both appearance and function. In this report, we present a novel strategy of reconstructing nasal and perioral defect integrally, including the hair-bearing appearance using extended forehead expanded flap.
METHODS: During 2015 to 2017, a total of 22 patients with mid-face defect underwent reconstruction with extended forehead expanded flap. A single expander was buried underneath the conjunctional area of forehead and frontal scalp, following with expander inflation. The expanded forehead flap was harvested and rotated to cover this defect. The far end of the expanded flap which was hairy scalp was used to cover the upper lip defect. In cases with large perioral defect, we designed two separated flaps, each supplied by one supratrochlear artery. One flap with shorter pedicle was for nasal reconstruction and one with longer pedicle was for parioral use. The pedicle of longer flap was saved for upper lip recovery after pedicle interruption.
RESULTS: Satisfactory results were achieved in most of the cases. Seventy-three percent of patients assessed themselves as satisfactory for aesthetics, 86 percent patients assessed themselves as satisfactory for function.
CONCLUSION: Nasal and perioral reconstruction can be restored use a single forehead expanded flap by extending the flap to scalp. The expanded flap can be designed either to an single flap or split flaps according to the defected area. Mustache could be effectively reconstructed in male patients simultaneously.
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