Nasal Reconstruction in Traumatic Nasal Injury Lateral Nasal Artery - - PowerPoint PPT Presentation

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Nasal Reconstruction in Traumatic Nasal Injury Lateral Nasal Artery - - PowerPoint PPT Presentation

May 02, 2023 204 likes •354 views

Nasal Reconstruction in Traumatic Nasal Injury Lateral Nasal Artery Perforator Flap Application in Case Report Ming-Chuan Lu, Li-Fu Cheng, Jiun-Tat Lee Department of Plastic Surgery Hualien Tzu-Chi Hospital, Taiwan, R.O.C. Nothing to discose

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Ming-Chuan Lu, Li-Fu Cheng, Jiun-Tat Lee Department of Plastic Surgery Hualien Tzu-Chi Hospital, Taiwan, R.O.C.

Nasal Reconstruction in Traumatic Nasal Injury— Lateral Nasal Artery Perforator Flap Application in Case Report

Nothing to discose

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Brief History

  • 85/M farmer, with DM,

HTN

  • Traumatic injury by

knife  subtotal nasal amputation

  • 4*4 cm open wound

with skin and soft tissue defect, deep into cartilage level

  • Nasal sidewall, dorsum,
  • bil. ala all involved
  • Tip partial involved
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SLIDE 3

Flap Design and Surgical Approach

Facial artery Lateral nasal artery and perforator

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SLIDE 4

Flap Elevated And Divided

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SLIDE 5

Flap Inset and Immediate Post-OP

Perforator was seen Lateral nasal artery perforator flap and rotate 135 degree

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2 Weeks Follow Up

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SLIDE 7

1 Month Follow Up

Mild depressed nostril

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SLIDE 8

18 Months Follow Up

The patient got very satisfied about his nose

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SLIDE 9

Common Choices In Nasal Reconstruction

  • Banner flap
  • Bilobed flap
  • Glabellar flap
  • Dorsonasal flap
  • Nasalabial flap
  • Cheek flap
  • Forehead flap
  • Scalping flap
  • Temporomasoid

flap (Washio flap)

  • Size (small or large)
  • Location (subunits involved)
  • Individual consideration….
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SLIDE 10

LNA Perforator Flap

  • Size and location of the defect
  • The LNA perforator flap can be adopted for

defects in any fashion without any mobilizing restrictions

  • It can be rotated 90~180 degrees as a

propeller flap or transposed or advanced

  • Venous congestion (30%, but all relief)
  • -Single-Stage Ala Nasi Reconstruction: Lateral Nasal Artery Perforator Flap J Craniofac Surg 2010
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One Stage verse Two stage ?

  • Most were two stage and even three
  • Literature showed that

 LNA perforator flap not only contributes thin and pliable soft tissue coverage but also provide an one stage nasal reconstruction

  • Individual consideration and patient’s
  • pinion
  • -Single-Stage Ala Nasi Reconstruction: Lateral Nasal Artery Perforator Flap J Craniofac Surg 2010
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Summery

  • The LNA perforator flap provided pliable

soft tissue coverage and enough volume in nasal reconstruction

  • Donor site scar can be easily concealed
  • Similar color, thickness and texture
  • Need full evaluation and assessment, well

communication and explanation

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Hualien Tzu-Chi Hospital, Taiwan, R.O.C