Reconstruction of the columella and the tip of the nose with an island-shaped forehead flap

Dejan Vulovic, Nenad Stepic, Aleksandar Pavlovic, Sasa Milicevic, Branislav Piscevic
2011 Vojnosanitetski Pregled  
Background. Posttraumatic and postoperative defects of columella and the tip of the nose are difficult to reconstruct. There are several operative methods described in the literature, and many of them are step-by-step procedures with long duration. The aim of this study was to present one-step procedure for reconstruction of the columella and the tip of the nose with island-shaped arterial forehead flap. Case report. A 45-year old man was submitted to surgical excision of basocellular skin
more » ... ocellular skin cancer. After the excision, a defect of the columella and tip of the nose the remained, 3 × 2.5 cm in dimensions, with exposed alar cartilages. During the same operation, the defect was covered with an island-shaped arterial forehead flap. Postoperative one-year course was uneventful, without signs of tumor recurrence after one year, and further surgical corrections were unnecessary. Conclusion. Considering the results of our operative technique, we believe that middle island-shaped forehead flap is suitable for reconstruction of the columella and the tip of the nose, due to the following reasons: safe vascularization of flap, similarity of the transferred tissue with the excised one, the procedure is completed in one step, simple surgical technique and uncomplicated healing of a flap-harvesting site. Key words: skin neoplasms; reconstructive surgical procedures; nose neoplasms; treatment outcome. Apstrakt Uvod. Posttraumatski i postoperativni defekti kolumele i vrha nosa su teški za rekonstrukciju. Ima više opeativnih metoda opisanih u literaturi. Većina njih su višeaktovne i obavljaju se korak po korak. Cilj ovog rada bio je da se prikaže jednofazna procedura rekonstrukcije kolumele i vrha nosa primenom ostrvastog arterijalnog čeonog režnja. Prikaz bolesnika. Bolesnik, star 45 godina, bio je podvrgnut hirurškom uklanjanju bazocelularnog karcinoma kože. Posle hirurške intervencije ostao je defekt veličine 3 × 2,5 cm na kolumeli i vrhu nosa sa eksponiranom alarnom hrskavicom. Tokom operacije defekt je pokriven ostrvastim arterijskim čeonim režnjem. Postoperativni tok u narednih godinu dana bio je bez komplikacija, bez znakova recidiva tumora, te dalje hirurške korekture nisu bile potrebne. Zaključak. Na osnovu rezultata hirurške tehnike koju smo primenili možemo zaključiti da je ostrvasti čeoni režanj pogodan za rekonstrukciju kolumele i vrha nosa jer ima pogodnu vaskularizaciju, tkivo mu je slično uklonjenom, a procedura se obavlja u jednoj fazi, hirurška tehnika je jednostavna i postoperativni tok je bez komplikacija.
doi:10.2298/vsp1103277v pmid:21524008 fatcat:skirzkzusvdpzgsdirlbpd6dge