The Evaluation Reliability Of Nasal Defect Repaired By Forehead Flap

Objective:The use of forehead flap for nasal reconstruction is an important means of nasal defect repair.Through a retrospective review of the surgical methods and detailed operation details of the forehead flap for 10 years,the reliability and effectiveness of the forehead flap rhinoplasty are evaluated.Methods:The cases of nasal defect repaired by the forehead flap from October 2007 to February 2018 were reviewed and analyzed from the basic data of the patients,the position of the defect,the treatment plan,the stage of the operation,the treatment process,the use of the cartilage graft,the reconstruction of the nasal lining,the closure of the donor area,and the complications.Results:The nasal reconstruction of the forehead flap was performed in 124 cases.The way of injury,traumatism in 104 cases(83.9%),neoplasm in 18 cases(14.5%),else in 2 cases(1.6%).Lesion location:total nose(nasal tip,nasal alar and columella simultaneously involved)in 70 cases(56.5%),nasal alar in 36 cases(29%),nasal tip in 18 cases(14.5%).Repair method:predilated forehead flap was used to repair nasal defect in 100 cases(80.6%).The operation was divided into dilator implantation,forehead flap nasal reconstruction,flap pedicle operation,and 3 stages were performed.The expansion time of the flap was 70-90 days.The forehead flap was designed as a oblique flap with a trochlear artery.After 2 stage of operation,there were 3 stages of pedicle dissection on the 60-70 day.There were 24 cases(19.4%)of nasal defect repaired without expansion forehead flap.The operation was divided into 1 stages of frontal flap,nasal reconstruction,lateral thigh skin grafting,donor site grafting,and 2 stage flap pedicle operation.There were 106 cases(85.5%)of reconstruction and repair of the lining,18 cases(14.5%)of the nasal supporting structure were reconstructed by costal cartilage.Complications occurred in 3 cases(2.4%),flap necrosis or flap necrosis.Conclusions:Forehead flap is a reliable and effective method for nasal reconstruction.It can effectively treat various nasal defects.predilated forehead flap method,a total of 3 stages of operation,can make direct suture of the skin of the donor area;no expansion of the forehead flap method,a total of 2 stages of surgery,the immediate operation,the need for skin grafting.Under the circumstances permit,we should first consider the use of pre expanded forehead flap.In general,forehead flap is a safe and effective way to repair nasal defects.