Outcomes of paramedian forehead flap for reconstruction of large nasal defects: Menoufia experience

ObjectiveThe aim of this case series study was to evaluate outcomes of paramedian forehead flap in reconstruction of large nasal defects.BackgroundNasal reconstruction is a challenging pursuit owing to its complex three-dimensional structure; the different components of skin, bone, cartilage, and mucosal lining; and the variations in skin thickness and color of the nose. This study describes forehead flap technique for reconstruction of large nasal defects more than 2 cm after excision of a neoplasm.Patients and methodsFrom January 2012 to December 2015, 14 patients who had large nasal defects received surgical treatment in the form of either expanded paramedian forehead flap (group A, n = 5 patients) or nonexpanded paramedian forehead flap (group B, n = 9 patients). Demographic data, nasal defect characteristics, postoperative complications (infection, wound dehiscence, and flap necrosis), comparison between two groups of patients, and doctor and patient satisfaction were recorded.ResultsThe overall results were satisfactory regarding function and appearance without major complications according to patient and doctor satisfaction. Wound dehiscence occurred in one (7.14%) case and healed with conservative treatment. Another patient (7.14%) was complicated with infection at the site of expander port and was treated with antibiotics.ConclusionThe forehead flap continues to be one of the best options for closure of surgical defects of the nose larger than 3 cm. Adequate knowledge and careful application of the technique and its modifications allows excellent results to be obtained with few complications.