Use of bilateral lateral nasal flaps sharing a single skin pedicle for repair of large midline nasal dorsum defects: A novel technique enabling maximal defect closure and minimal donor-site morbidity

Abstract

Background: This study aimed to evaluate the utility of bilateral axial, lateral nasal flaps sharing a single skin pedicle in the reconstruction of large midline nasal dorsum defects. Materials and Methods: Six patients with large midline nasal dorsum defects due to tumor ablation (four basal cell carcinomas and two squamous cell carcinomas) were included in this study. Nasal defects were reconstructed by bilateral axial, lateral nasal flaps that easily reached nasal dorsal defect bilaterally. After the two parts of the flap were sutured on the dorsum of the nose, the donor area defects on each side of the flap were easily closed by pulling the cheek skin toward the flap sides. Results: After an average of 10 months of follow-up, the color and texture matches were good, and all the scars were at the borders of the esthetic units and symmetrical. Share of single pedicle by the two lateral nasal flaps enabled larger defect closure, and the likelihood of lengthening of the flap through the nasolabial sulcus bilaterally to enable the closure of nasal tip defects. Preparation of relatively smaller size flaps enables the formation of smaller defects in the donor site which could easily and safely be repaired with minimal complication risk. There were no complications related with the flaps or donor sites, except for venous congestion in one patient, and neither a tumor relapse nor a metastasis was detected. Conclusion: In conclusion, our findings revealed feasibility and safety of using bilateral axial, lateral nasal flaps sharing a single skin pedicle in repair of large midline nasal dorsum defects due to tumor ablation, which enables maximal defect closure and minimal donor-site morbidity.