gms | German Medical Science

81. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

12.05. - 16.05.2010, Wiesbaden

Aesthetic aspects of partial and total nasal reconstruction – the subunit principle

Meeting Abstract

  • corresponding author presenting/speaker Philipp A. Federspil - Univ.-HNO-Klinik, Heidelberg, Germany
  • Frank Wallner - Univ.-HNO-Klinik, Heidelberg, Germany
  • Christian Simon - Univ.-HNO-Klinik, Heidelberg, Germany
  • Peter K. Plinkert - Univ.-HNO-Klinik, Heidelberg, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hno087

doi: 10.3205/10hno087, urn:nbn:de:0183-10hno0870

Veröffentlicht: 6. Juli 2010

© 2010 Federspil et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Background: Nasal defects cause a serious psychological burden for the patient. The subunit principle improved aesthetic nasal reconstruction to a large extent. It is crucial to adapt the defect to the aesthetic subunits, in order to achieve best possible camouflage of the resulting scars. The second important principle is reconstruction of all three layers.

Material and methods: From 2006 until 2009, full thickness nasal defects greater than 1.5 cm were reconstructed in three layers and according to the subunit principle in 6 patients. There were 1 female and 5 male patients with an age range from 53 to 81 years.

Results: 5 nasal defects were partial and 1 was total. In 1 case the cheek was reconstructed with a large cheek rotation flap. For inner lining various flaps were used: septal mucoperichondrial flap (2), turn-in flap of nasal skin (1), split thickness skin (1), forehead flap (1), and microvascular forearm flap (1). For reconstruction of architecture it was made use of: pivot flap of septal cartilage (2), ear cartilage (5), and costal cartilage (1). For nasal skin cover, the paramedian forehead flap was used exclusively in three stages. All patients ware happy with the cosmetic result.

Conclusions: The three layered nasal reconstruction including the subunit principle offers acceptable aesthetic results.