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Nasal Defects (nasal + defect)
Selected AbstractsCombined Linear Closure and Burow's Graft for a Dorsal Nasal DefectDERMATOLOGIC SURGERY, Issue 1 2006DANIEL S. BEHROOZAN MD First page of article [source] Introduction to Flap Movement: Reconstruction of Five Similar Nasal Defects Using Different FlapsDERMATOLOGIC SURGERY, Issue 2005Elbert H. Chen MD Background. There are several options for closure of a given surgical defect after tumor extirpation is confirmed. Flap reconstruction is one of these options. Objective. The purpose of this article is to introduce the three basic types of flap movement: advancement, rotation, and transposition. Methods. Five similar defects located on the nasal sidewall were repaired, each using a different flap design. Results. The optimal flap design for a given defect on a particular patient is based on the answers to a series of questions: Where is the available tissue reservoir? How can tissue be mobilized from the reservoir to cover the defect? How do the resulting tension vectors affect critical structures? Where are the final incision lines? Conclusion. Many factors must be evaluated before determining a method of reconstruction. Flap reconstruction requires a thorough understanding of anatomy and tissue movement. [source] A New Approach to the Reconstruction of Extensive Congenital Midline Nasal DefectsTHE LARYNGOSCOPE, Issue 10 2004Ryan Gilbert BS No abstract is available for this article. [source] The east,west advancement flap (horizontal advancement flap) to repair a defect on the nose alaJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2010A Ascari-Raccagni Abstract Background, The repair of an alar nasal defect is a frequent challenge for dermatologic surgeons for reasons of the high rate of non-melanoma cancers in the area. Objective, Our aim was to describe the use of an east,west cheek-based flap (horizontal advancement flap) to repair a surgical defect on the nose ala. Methods, Benefits and limits of this surgical procedure are evaluated. Result, The resulting S-shaped scar was well-camouflaged among the natural skin lines (melolabial fold and melonasal junction). No architectural distortion of the nose resulted from the procedure. Conclusion, In selected patients with small-to-medium-size defects of the nasal ala, the horizontal advancement flap is a simple, reliable and aesthetic reconstruction option. [source] Osseous Tissue Engineering With Gene Therapy for Facial Bone Reconstruction,THE LARYNGOSCOPE, Issue 7 2001William H. Lindsey MD Abstract Objective Facial osseous defects remain a major functional and esthetic challenge for the head and neck surgeon. Tissue engineering may provide advantageous alternatives to conventional therapies. The objective of the study was to evaluate the efficacy of gene therapy in the repair of osseous facial defects. Study Design Blinded, controlled, prospective animal experiment. Methods Thirty adult athymic nude rats were divided into five groups of six animals. Three groups were used as control subjects. Two groups were treated with 3.75 × 108 viral particles containing recombinant type 5 adenoviral vectors. One group received viruses that coded for ,-galactosidase production, another received viruses that coded for bone morphogenetic protein (BMP-2) production. After 120 days rats were examined at necropsy with precise planimetry, histological analysis of new bone growth, and radio-densitometric analysis of bone thickness. Results Radio-densitometric measurements showed that BMP-2,treated nude athymic rats had significantly enhanced osseous repair compared with control subjects when evaluated by both radio-densitometry and histological examination. Conclusion Gene therapy,treated, immunosuppressed rodents had an enhanced osteoinductive repair of a dorsal osseous nasal defect. [source] Modified Single-Sling Myocutaneous Island Pedicle Flap: Series of 61 ReconstructionsDERMATOLOGIC SURGERY, Issue 11 2008ANDREA WILLEY MD BACKGROUND Bilevel undermining above and below the transverse nasalis muscle in the construction of a myocutaneous island pedicle flap produces a bilateral or unilateral muscular sling with exceptional vascular supply for reconstruction of defects on the distal nose. We present further modification of the single-sling myocutaneous island pedicle flap that expands its application to a wide variety of nasal defects and further defines its usefulness in nasal reconstruction. METHODS A series of 61 consecutive myocutaneous island pedicle flap reconstructions performed after Mohs surgery between March 2005 and July 2006 are presented. Flap modifications are presented, and advantages and limitations are discussed. RESULTS Flap modifications introduce additional reach and rotational mobility to the flap that permit extension of the flap to defects on the nasal tip and distal ala. CONCLUSION Modifications of the bilevel approach to the single-sling nasalis myocutaneous island pedicle flap further define its practicality in nasal reconstruction and expand its application to a variety of nasal defects. [source] Forehead Donor Site Full-Thickness Skin GraftDERMATOLOGIC SURGERY, Issue 3 2005Vassilios Dimitropoulos MD Background Full-thickness skin grafts (FTSGs) are useful for reconstructing nasal defects. Traditional reported donor sites include the preauricular, postauricular, supraclavicular, clavicular, conchal bowl, melolabial fold, and upper eyelid skin. Selection of the "best" donor site is based on the "best" tissue match and ability to camouflage the donor scar. Objective The purpose was to report our experience with FTSGs harvested from the forehead for reconstruction of nasal defects following Mohs' surgery. Methods A retrospective query of the Mohs' surgery database was performed to identify nasal defects repaired with a FTSG harvested from the forehead skin. The research record contained the patient age and gender, defect size, and cosmetic and functional outcomes interpreted by the patient and surgeon. Results FTSGs from forehead skin were used to repair the nasal defects in three patients. The functional and cosmetic outcome of all three cases was deemed excellent by the patient and surgeon. Donor site scars were well concealed within preexisting rhytids. Conclusion FTSGs harvested from the forehead, although limited in practical utility, may offer an optimal FTSG match for limited select defects while also providing an easily camouflaged donor site scar within a forehead rhytid. VASSILIOS DIMITROPOULOS, MD, CHRISTOPHER K. BICHAKJIAN, MD, AND TIMOTHY M. JOHNSON, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] The Versatility of the Nasolabial Flap Enhanced by the Delay ProcedureDERMATOLOGIC SURGERY, Issue 2 2001Isaac Zilinsky MD Background. The nasolabial flap is a versatile and effective option for the closure of nasal defects of the cheek and nasal sidewall following Mohs surgery. However, both extirpation of a tumor in the region of the base of the flap or previous use of the flap often destroy the proximal axial blood supply to the flap, excluding its immediate utilization. We describe a different use of the nasolabial flap and a technique for preserving its capacity in the case of reutilization Objective. To describe the versatility of the nasolabial flap and a delay procedure that enables its exploitation despite prior disruption of the proximal blood supply. Methods. Three different uses of the same nasolabial flap are demonstrated in one patient. The surgical techniques are discussed in detail. Results. The reconstructive results were excellent. There were no postoperative complications. Conclusion. The nasolabial flap is a versatile and effective option for the closure of nasal defects of the cheek and nasal sidewall. When the nasolabial flap has been used before, or its blood supply compromised, the delay procedure can reestablish its applicability. [source] Reconstruction of Nasal Defects Larger Than 1.5 Centimeters in Diameter ,THE LARYNGOSCOPE, Issue 8 2000Stephen S. Park MD Abstract Objective To review the repair of larger nasal defects (>1.5 cm in diameter) and the vascular supply to the forehead flap. Study Design Retrospective chart review (1994,1999) and cadaver analysis of forehead flap vasculature. Methods Chart review was made of patients with cutaneous nasal defects greater than 1.5 cm in diameter. An intravascular silicone cast was used to detail the arterial supply to forehead flaps focusing on contribution from the supratrochlear and angular vessels. Results In 127 patients with nasal defects, 76 defects were greater than 1.5 cm in diameter and were repaired with a midline forehead flap (44 [58%]), paramedian forehead flap (3 [4%]), single-stage midline forehead flap (8 [11%]), interpolated melolabial flap (5 [7%]), local nasal flap (7 [9%]), or skin graft (9 [12%]). All original defects were modified to some degree with an aggressive application of the nasal esthetic subunit principle. Forty-three patients (57%) had cartilage grafts, 18 (24%) had a full-thickness defect requiring repair of the internal lining, and 11 (14%) had some degree of complication, although no patient had full-thickness necrosis of a flap or required a second flap. Analysis of the vascular pedicle to the midline and paramedian forehead flaps demonstrated significant contributions from the angular artery. Skin paddles from a midline and paramedian forehead flap had similar vascular arcades. Conclusions Nasal reconstruction has reached a standard of consistent esthetic results with restoration of nasal function. The midline forehead flap is dependable and robust and leaves a donor site scar consistent with the principle of esthetic units. [source] | ||||||||||