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The pericranial flap for inner lining of full-thickness nasal defects: a retrospective cohort study

Published online by Cambridge University Press:  06 April 2022

T Lewis ,
R Care ,
V Kuta ,
S Secord Open the ORCID record for S Secord [Opens in a new window] ,
J Trites ,
M Corsten ,
M Rigby  and
S M Taylor
T Lewis
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Canada
R Care
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Canada
V Kuta
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Canada
S Secord*
Affiliation:
Faculty of Medicine, Dalhousie University, Halifax, Canada
J Trites
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Canada
M Corsten
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Canada
M Rigby
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Canada
S M Taylor
Affiliation:
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Canada
*
Author for correspondence: Ms Sabrina Secord, Division of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Dalhousie University, 6299 South Street, Halifax, NS, Canada B3H 4R2 E-mail: SSecord@dal.ca
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Abstract

Background

Effective nasal reconstruction requires skin and soft tissue cover, cartilage or bone structure, and mucosal lining. Ideal lining is thin, pliable and vascularised, making reconstruction challenging. This paper presents the first case series with long-term outcomes of pericranial flaps used as inner lining for nasal reconstruction.

Methods

Patients undergoing paramedial forehead flaps from 2007 to 2019 were identified using second-stage nasal reconstruction billing codes. Patients with pericranial flaps for lining, for whom there were data on resulting outcomes and complications, were identified.

Results

Sixty-six patients underwent second-stage nasal reconstruction. Eighteen patients had paramedian forehead and pericranial flaps for inner lining reconstruction. The flap lining had no immediate post-operative complications. Three patients suffered partial to major reconstructive failure post radiotherapy. Other complications included nasal stenosis and orocutaneous fistula.

Conclusion

Combined with paramedian forehead flaps, the pericranial flap is reliable as inner lining for nasal reconstruction. It is easily accessible and useful in resections with limited mucosal options.

Keywords

Head And Neck NeoplasmsReconstructive Surgical ProceduresSkin NeoplasmsNasal CancerSurgical Flaps
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 5 , May 2023 , pp. 532 - 536
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Ms S Secord takes responsibility for the integrity of the content of the paper

References

Menick, FJ. The evolution of lining in nasal reconstruction. Clin Plast Surg 2009;36:421–41CrossRefGoogle ScholarPubMed
Cannady, SB, Cook, TA, Wax, MK. The total nasal defect and reconstruction. Facial Plast Surg Clin North Am 2019;17:189–201CrossRefGoogle Scholar
Aneeshkumar, MK, Chueng, K, Hart, R, Trites, J, Taylor, SM. Pivoted composite nasal septal flap for reconstruction of the nose. Eur Arch Otorhinolaryngol 2013;270:2445–50CrossRefGoogle ScholarPubMed
Ramji, M, Kim, GY, Pozdnyakov, A, McRae, MH. Microvascular lining options for subtotal and total nasal reconstruction. A scoping review. Microsurgery 2019;29:563–70CrossRefGoogle Scholar
Sertel, S, Pasche, P. Pericranial flap for inner lining in nasal reconstruction. Ann Plast Surg 2016;77:425–32CrossRefGoogle ScholarPubMed
Phillips, TJ. Total nasal reconstruction: a review of the past and present, with a peak into the future. Curr Opin Otolaryngol Head Neck Surg 2019;27:420–5CrossRefGoogle ScholarPubMed
Balagopal, PG, George, NA, Ajith, R, Ahamed, MI, Sebastian, P. Anterior skull base reconstruction after cranio-facial resections using galeal pericranial flap. Gulf J Oncolog 2014;1:84–8Google ScholarPubMed
Yoshioka, N, Rhoton, AL. Vascular anatomy of the anteriorly based pericranial flap. Neurosurgery 2005;57:11–16Google ScholarPubMed
Potparić, Z, Fukuta, K, Colen, LB, Jackson, IT, Carraway, JH. Galeo-pericranial flaps in the forehead: a study of blood supply and volumes. Br J Plast Surg 1996;49:519–28CrossRefGoogle ScholarPubMed
Gonzalex-Ulloa, M, Castilla, A, Stevens, E, Alvarex Fuertes, G, Leonelli, F, Ubaldo, F. Preliminary study of the total restoration of the facial skin. Plast Reconstr Surg 1954;13:151–61CrossRefGoogle Scholar
Burget, GC, Menick, FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg 1985;76:239–47CrossRefGoogle ScholarPubMed
Faris, C, Heiser, A, Quatela, O, Jackson, M, Tessler, O, Jowett, N et al. Health utility of rhinectomy, surgical nasal reconstruction, and prosthetic rehabilitation. Laryngoscope 2019;130:1674–9CrossRefGoogle ScholarPubMed
Weber, SM, Wang, TD. Options for internal lining in nasal reconstruction. Facial Plast Surg Clin North Am 2011;19:163–73CrossRefGoogle ScholarPubMed
Miles, B, Davis, S, Crandall, C, Ellis, E. Laser-Doppler examination of the blood supply in pericranial flaps. J Oral Maxillofac Surg 2010;68:1740–5CrossRefGoogle ScholarPubMed
Harrison, L, Sieffert, M, Kadakia, S, Kadakia, S, Johnson, RM, Ducic, Y. Reconstruction of a subtotal septorhinectomy defect with a chimeric paramedian-pericranial forehead flap. Am J Otolaryngol 2019;40:445–7CrossRefGoogle ScholarPubMed
Potter, J, Ducic, Y, Ellis, E 3rd. Extended bilaminar forehead flap with cantilevered bone grafts for reconstruction of full-thickness nasal defects. J Oral Maxillofac Surg 2005;63:566–70CrossRefGoogle ScholarPubMed