Nasal Reconstruction Flashcards Preview

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Flashcards in Nasal Reconstruction Deck (7)
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1
Q

What are goals of nasal reconstruction

A
  • maintain patent airway
  • restrore missing layers
  • optimize aesthetics
2
Q

What is critical about the subunits (convex vs concave)

A

CONCAVE

  • sidewalls
  • soft triangles

CONVEX

  • tip
  • columella
  • ala-nostril sills
  • dorsum

If more than 50% of subunit is involved, whole subunit should be excised and reconstructed if CONVEX. The concave subunits dont follow this b/c jx lines dot show in shadowed area and dorsum

3
Q

What is DDx of Nasal defect

A

Congenital

  • Agenesis (arhinia)
  • Hypoplasia (nasal cavity stenosis/atresia)

Acquired

  • Inflammatory (wegeners granulomatosis, rhinophyma)
  • Iatrogenic (post septorhino)
  • trauma
  • neoplastic
  • drugs (cocaine)
4
Q

How do you decide TIMING of nasal reconstruction

A

Delayed if

  • perineural invasion or bone invasion
  • postive margins
  • RTx required in short term
  • infected/dirty wound
5
Q

What are the three componenets for nasal recosntruction

A
  1. Nasal Lining
  2. Nasal support
  3. Nasal soft tissue coverage
6
Q

What are the options for reconstruction of nasal lining?

A
  1. Septal mucoperichondrial flap (Millard)
  2. Septal pivot flap
  3. Septal trapdoor flap (De Quervains)
  4. Bipedicle mucosal advancement flap
  5. Skin graft
  6. Turn-in flap
  7. Modification of forehead flap
  8. Nasolabial flap
  9. Buccal mucosal flap
  10. Free flap (RFFF, FDMA, composite rib/serratus)
7
Q
A