Flip and Fold Technique Using a Nasolabial Flap for Reconstructing Complete, Full Thickness Nasal Alar Defect

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R. Austero

Amang Rodriguez Memorial Medical Center, Philippines

: J Otol Rhinol

Abstract

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Repairing a full thickness nasal alar defect is extremely challenging for surgeons due to the following reasons: 1) the ala has a complex contour, 2) its unique color and texture, 3) the need for mucosal surface lining support to alleviate wound contraction, and 4) maintenance of the air flow1. Therefore, the choice of flap source, flap size, and sources of lining and structural support is very important. There are many techniques available with very acceptable outcomes.2 However, the choice of flap depends on the surgeon’s skills and expertise3. In this case report, our aim is to present an alternative technique using nasolabial flap with conchal cartilage in the reconstruction of a full thickness alar defect. A 24 year old male presented at our institution with a complete full thickness right alar defect secondary to a 3-month history of trauma. The defect was repaired using an ipsilateral nasolabial flap and conchal cartilage graft. The conchal cartilage was used to establish structural support, while the nasolabial flap was utilized for mucosal and dermal coverage. A nasolabial flap was used due to its softness, malleability and convexity. In addition, the proximity of the nasolabial fold to the nose facilitates easy transposition of the flap4. The flap was made to approximate the size, shape, and thickness of the reconstruction with that of the uninvolved ala allowing symmetry of the whole nose. The result of the flaps fit the defect areas adequately and provided enough coverage for the alar defects. In addition, the framework support provided by the cartilage tissue and bolster improved the shape of the ala. Lastly no malformations or functional losses in the nose were observed. We concluded that the “flip and fold” technique can be an option in reconstructing a complete full thickness nasal alar defect.

Biography

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Dr. Rainier M. Austero finished his Bachelor degree in Medical Technology in Emilio Aguinaldo College and is also a licensed laboratory scientist, He took his Medical Degree In Medicine in University of Perpetual Help Dr. Jose G. Tamayo Medical Center. And is now the Chief Resident of Department of Otorhinolaryngology Head & Neck Surgery in Amang Rodriguez Memorial Medical Center in Marikina City, Philippines.