11. Defect
โข Small : <1.5 cm
โข Superficial: skin and subcutaneous loss
โข Large: > 1.5cm
โข Deep : support /lining defect
โข Adversely located : necessitates a regional flap
โข Composite: extend to adjacent lip /cheek
13. Contโฆ
โข Use the contralateral normal or the ideal as a
guide
โข Replace tissues in exact dimensions and
outline
โข Employ templates
โข Like with like
14. Cont.โฆ
โข Understand wound healing and tissue transfer
โ Graft /flap
โข Build on a stable platform
โข Restore the subcutaneous framework of hard
and soft tissue
32. Restoring nasal lining
โข Nearly as much skin is required to line a nose
as is needed to cover its outer surface.
โข Raw area heals secondarily, distorting the
external nasal shape
โข Options
33. Composite skin grafts
โข Composite skin grafts of skin and cartilage,
taken from the ear
โข Small defects (0.5โ1.0 cm) along the nostril
margin or within soft triangle
56. Summary
โข Nasal defect needs a 3D reconstruction
โข Nasal cover options include primary closure,
grafts or flaps
โข Hard tissue support replacement can be
achieved from ear, septum or rib
โข Inner lining reconstruction is as important as
nasal covering.
57. References
โข Neliganโs 4th edition , volume three
โข Grab and smith 8th edition
โข Local flaps in facial reconstruction , Shan R.
Baker.โThird edition
โข An Algorithm for Treatment of Nasal Defects
Brian M. Parrett, MD, JulianJ. Pribaz, MD*