Nasal Reconstruction Using Two Staged Nasolabial Flap

Dr. Ramprabhu Musham*¹

Corresponding Author: Dr. Ramprabhu Musham, Consultant Plastic Reconstructive Aesthetic and Microvascular Surgeon, PKDAS INSTITUTE OF MEDICAL SCIENCES. Ottapalam, Palakkad Kerala 679522 India.

Copy Right: © 2023  Dr. Ramprabhu Musham, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received Date: March 03, 2023

Published Date: March 15, 2023

Abstract

Facial trauma is a common presentation in emergency departments, and nasal injuries are frequently encountered (1). We present a case of a 33-year-old male who had full thickness tissue loss of the nasal tip left alae and collumella, and a full-thickness wound of the upper lip following a road traffic accident. Wound debridement and repair of the lip were performed, followed by superiorly based left nasolabial flap cover. Second-stage flap division was done after 3 weeks followed by one surgery for revision after 3 more weeks under local anesthesia.

Introduction

Facial trauma is a common presentation in emergency departments, with nasal injuries frequently encountered (1). Nasal defects can result in significant functional and aesthetic impairment, and their reconstruction can be challenging. In this case report, we present a successful reconstruction of a nasal defect using a superiorly based nasolabial flap.

Case Presentation

A 33-year-old male was admitted to the emergency department following a road traffic accident. He had full thickness tissue loss of the nasal tip left alae and collumella and a full-thickness wound of the upper lip. Wound debridement and repair of the lip were performed, followed by superiorly based left nasolabial flap cover. Second-stage flap division was done after 3 weeks followed by one surgery for revision after 3 more weeks under local anesthesia.

Discussion

The superiorly based nasolabial flap has been described as a useful technique for nasal reconstruction (2). In this case, the flap was chosen due to its versatility and reliability. The staged approach, including second-stage flap division and revision surgery under local anesthesia, allowed for a satisfactory final result. Local anesthesia is a useful approach for revision surgeries and has been studied extensively (3,4). The vascular anatomy of the nasolabial flap has also been studied, and a thorough understanding of the blood supply to the flap can help minimize complications and improve outcomes (5).

Conclusion

The use of a superiorly based nasolabial flap was successful in reconstructing the nasal defect in this patient. This case highlights the importance of careful wound management and selection of appropriate reconstructive techniques.

References

1. Cigna E, Zenga F, Mazzola F, et al. Facial trauma: a review of the literature and case reports. Acta Biomed. 2018;89(S5):17-23.

2. Kroll SS. Nasal reconstruction using the superiorly based nasolabial flap. Plast Reconstr Surg. 1989;84(4):572-576.

3. Carlsen BT, Villa MT, Cockerham KP, et al. Local anesthesia: a practical approach. Mayo Clin Proc. 2019;94(7):1259-1271.

4. Koehler J, Milner RH. Local anesthesia in plastic surgery. Plast Reconstr Surg. 2015;135(4):1097-1106.

5. Gosain AK, Chang N, Mathes SJ, et al. A study of the vascular anatomy of the nasolabial flap. Plast Reconstr Surg. 1993;92(2):315-323