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Case Reports
. 2021 Sep;7(5):1524-1529.
doi: 10.1002/vms3.548. Epub 2021 Jun 15.

Reconstruction of a large nasal-facial defect using an augmented temporal myocutaneous tube flap in a dog

Mei-Jyun Ciou  1 , Lih-Seng Yeh  1   2
Affiliations
Case Reports

Reconstruction of a large nasal-facial defect using an augmented temporal myocutaneous tube flap in a dog

Mei-Jyun Ciou et al. Vet Med Sci. 2021 Sep.

Abstract

The muzzle region of dogs contains various composite tissues, which are challenging to recreate during reconstruction. Small or moderate facial/nasal defects can be closed primarily or left for second-intention healing. However, larger defects require the application of composite tissue or labial advancement flaps. Axial pattern flaps based on the caudal auricular artery, superficial temporal artery (STA), angularis oris artery, and other cutaneous arteries have been reported. In our case, we aim to report the reconstruction of a large composite defect of the rostral and dorsal nasal regions in a dog using an augmented, axial myocutaneous flap based on bilateral STAs. This is a clinical report on a spayed female mixed-breed dog (age, 7 years; weight, 15 kg), in which a large-scale nasal-facial composite tissue defect was surgically reconstructed using an axial myocutaneous flap based on bilateral STA branches. A delay technique was applied to prefabricate the flap to enrich the blood supply. New nostrils were created on a folded, rostral hard palate. As a result, the axial tube rotational flap was successfully transferred. The use of delay technique for prefabricating the tube flap optimized its size and survival. In addition to the folded rostral hard palate, the flap fully closed the defects on the face and nose. Functional and cosmetic outcomes were satisfactory, with minimal donor-site morbidity. In, conclusion, a large-scale nasal-facial defect in a dog was successfully reconstructed using an augmented tube pedicle flap based on the bilateral STAs, which may, thus, be used to repair very large facial-nasal defects in dogs.

Keywords: dog; muzzle; nasal-facial defect; pedicle flap.

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Conflict of interest statement

The authors declare no conflict of interest related to this report.

Figures

Figure 1
Figure 1
(a and b) The maxillary region of the dog was extensively destroyed and deformed with severe inflammation
Figure 2
Figure 2
3D reconstructed skull image revealing the destruction of bony structures
Figure 3
Figure 3
(a) A tube pedicle flap was designed based on the bilateral superficial temporal arteries (STAs). (b) The tube was created by closing the bipedicle flap edges with sutures, and the donor site was primarily closed
Figure 4
Figure 4
The flap was 'delayed' by half cutting the right base of the flap, and the right superficial temporal vessel was also severed
Figure 5
Figure 5
The circumferential edge of the facial‐nasal defect was sharply trimmed so as to create a fresh wound margin to receive the flap
Figure 6
Figure 6
(a and b) The cosmetic outcome of the patient and the healed flap 2 months after the reconstruction
See this image and copyright information in PMC

References

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