Nasalis Island Pedicle Flap for Reconstruction of the Nasal Defect

Suh, Sung Won; Kim, Hoon Soo; Kim, Su Han; Ko, Hyun Chang; Kim, Byung Soo; Kim, Moon Bum; Jung, Do Sang

Abstract

BACKGROUND
Reconstruction of surgical defects of the nose is often challenging. There are many repair options for a nasal defect, including second-intention healing, primary closure, a skin graft and a skin flap. Among these, the nasalis island pedicle flap is a random pattern advancement flap that has satisfactory vascular supplies from the underlying muscular structure.
OBJECTIVE
We wanted to describe the surgical technique of creating a nasalis island pedicle flap and to report on our experience with the postoperative cosmetic outcome.
METHODS
Fourteen patients diagnosed with non-malignant melanoma skin cancer on the nose were treated with Mohs micrographic surgery (MMS). The surgical defects were reconstructed with a nasalis island pedicle flap. The size of the tumor and the postoperative surgical defects, the local complications and the cosmetic outcomes were assessed.
RESULTS
The size of the primary defects ranged from 0.8 to 2.3 cm at the greatest dimension (with a mean of 1.51 cm). Five cases were located on the nasal ala, three on the nasal dorsum, two on the nasal root, two on the nasal side wall and two on the nasal tip. During the follow-up period, there was no significant postoperative bleeding, necrosis and infection. There was no tumor recurrence and most of the patients showed minimal discernable scarring with satisfactory aesthetic outcomes.
CONCLUSION
A nasalis island pedicle flap provided aesthetically pleasing results, and it could be an useful method to reconstruct surgical defects in the nose after MMS.