gms | German Medical Science

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.