Ann Dermatol.  2008 Sep;20(3):142-145. 10.5021/ad.2008.20.3.142.

Combination Nasolabial Transposition Flap and Island Pedicle Flap Following Mohs Surgery of Simultaneous Basal Cell Carcinomas Involving Both Nasal Alae

• Lee CY
• Lee YK
• Choi KW
• Lee CW
• Kim KH
• Kim YH

• KMID: 2156381
• DOI: http://doi.org/10.5021/ad.2008.20.3.142

Abstract

The nasal ala is a challenging area for surgical reconstruction, with thick sebaceous skin, the lack of an ample tissue reservoir, and an adjacent free margin. Numerous flaps have been reported for the repair of alae defects. A 71-year-old woman with simultaneous basal cell carcinomas involving both nasal alae was treated by Mohs micrographic surgery. The surgical defects measured 1.5x1.5 cm on the center of the right nasal ala and 1.0x1.0 cm on the left nasal ala, including the alar crease and rim. The right nasal ala was used as a nasolabial transposition flap and the left nasal ala was reconstructed by an island pedicle flap. The final shape and texture were satisfactory. The flaps survived and nasal symmetry was preserved. Combined nasolabial transposition and island pedicle flaps thus offer a superior esthetic and functional result owing to minimized tension. This may be a valuable reconstructive option in the repair of bilateral nasal alae defects.

Keyword

Minimized tension flaps; Nasal alae defect; Simultaneous basal cell carcinomas

MeSH Terms

Aged
Carcinoma, Basal Cell
Female
Humans
Mohs Surgery
Skin
Succinates
Succinates

Figure

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  Fig. 1 (A) Two nodular plaques on both nasal alae. (B)Histologically, lesion on left nasal ala shows nodular basal cell carcinoma. (C) Also, lesion on right ala shows nodular basal cell carcinoma.

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  Fig. 2 (A) The surgical defects of the right nasal ala measured 1.5×1.5 cm on the lateral aspect including alar lobule and nasal sidewall through alar groove and the left nasal ala measured 1.0×1.0 cm on the lobule between alar rim and crease. (B), (C) The right nasal ala was used as a nasolabial transposition flap and the left nasal ala was reconstructed by an island pedicle flap.

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  Fig. 3 (A) Immediately following reconstruction with combination of the nasolabial transpositional flap on right nasal ala defect and the island advancement flap on left nasal ala defect. (B) 1 month after the reconstruction,the shape and texture of the nose were satisfactory. The nasal symmetry was preserved, and the patency of the airway was maintained.

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