[Application of modified paramedian forehead flap in reconstruction of nasal defect]

Abstract

Objective: To investigate the feasibility and significance of modified paramedian forehead flap for nasal defect and reconstruction.

Methods: Modified paramedian forehead flaps with forehead muscle in the pedicle were used in 2 patients with nasal reconstruction and 7 patients with nasal defects. The flaps were elevated subcutaneously with only forehead muscle in the pedicle at the supraorbital site. The degree of flap axis ranged from 90 degrees to 50 degrees. Inverted L-shape design was used for 3 cases with low hair line.

Results: Skin branch of supratrochlear vessel was observed running at the subcutaneous layer during the operation. 8 flaps all survived successfully with good texture and color. Partial necrosis happened in the distal end of one flap with subcutaneous pedicle, which healed through dressing.

Conclusions: Modified paramedian forehead flap, which includes muscle just in the pedicle, is based on the skin branch of supratrochlear vessel. The flap is very flexible and has reliable blood supply, leaving less morbidity in donor site. It also has good texture and skin color.