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Superiorly Based Nasal
Labial Flap
for Nose Reconstruction in a Patient With Skin Cancer
The tip of this flap was almost lost.
Close patient follow up saved the flap. The partial necrosis was
caused by two factors: The patient started to wear his eyeglasses, with
them resting on the base of his flap, and the flap had the maximum length
to width ratio of 2.5 to 1. The necrosis
reversed by having the patient stop wearing his eyeglasses and to use
pentoxifylline 400 mg t.i.d.
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1.
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2 |
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This
patient
has a basal cell carcinoma which had been
previously biopsied. |
The defect after Mohs Surgery. |
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The flap is outlined with a length to width ratio of
2.5 to 1.
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The
flap is rotated in place and sewn into position with little tension. |
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The flap is sewn in place. The flap had an excellent blood supply, thus,
the 2.5 to 1 ratio was used. |
The flap looked excellent 48 hours after surgery, but at 5 days the
tip started to die. Note the indentation on the patient's nose
where he has been wearing eyeglasses. The patient was placed on pentoxifylline 400 mg t.i.d. and instructed to
stop wearing his eyeglasses.
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7. |
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3 wk post-op result. Note the flap edema which is often present
with superiorly based flaps. The wearing of eyeglasses will worsen
the edema. The edema should slowly resolve over the course of months. |
3 wk post-op result. Note the flap edema which is often
present with superiorly based flaps. The wearing of eyeglasses will
worsen the edema. The edema should slowly resolve over the course of
months. |
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5 month post-op result-angled view. Note the flap's edema has
subsided. |
5 month post-op result-side view. Note the flap's edema has
subsided. |
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11. |
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5 month post-op result-front view. Note the flap's edema has
subsided. |
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13. |
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9 month post-op result-angled view. |
9 month post-op result-side view. |
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14. |
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9 month post-op result-front view. nbsp; |
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