Use of the Nasoseptal Flap for Inner Lining Reconstruction: Expanding Beyond Skull Base Repair

Summary: The pedicled mucoperichondrial nasoseptal flap was first described in 2006 for skull base reconstruction. Its use in this context is well documented and favored for its robust vascular supply and reliable outcomes; however, to our knowledge, its application in the reconstruction of nasal lining for full-thickness nasal defects has not been described. This case report details the use of the nasoseptal flap for staged reconstruction of a right heminasal defect following basal cell carcinoma resection. The nasoseptal flap is well suited for such extensive nasal reconstruction procedures due to its large size, substantial tissue integrity, and robust vascular supply. At 18 months postoperatively, the patient demonstrated excellent functional improvement using a clinically validated patient-reported outcome measures score. Both the patient and clinicians rated the cosmetic outcomes as excellent. From a technique standpoint, the flap requires endoscopic dissection and necessitates training in endoscopic nasal surgery. This report highlights the flap’s versatility and introduces a novel application that could be considered for similar complex nasal reconstructions.