A Review of the Pericranial Flap for the Inner Lining in Nasal Reconstruction with a Paramedian Forehead Flap
Authors List
Care, R. Christchurch Hospital, Christchurch, New Zealand
Lewis, T. Dallhousie University, Halifax, Canada
Taylor, S.M. Dallhousie University, Halifax, Canada
INTRODUCTION: Effective nasal reconstruction requires a three layer closure of skin, cartilage and mucosa. Skin reconstruction commonly utilises the paramedian forehead flap; reconstruction of the inner lining can be challenging. Multiple flaps have been described including the pericranial flap.
AIMS: Here we present a surgical overview of the procedure and a review of a single surgeon experience of the pericranial flap for inner lining for nasal reconstruction.
METHODS: A search of the patient database was performed using the billing code for the second stage nasal reconstruction from its introduction in 2007 – present; identifying patients who had received paramedian forehead flaps. A retrospective chart review of these patients was then performed to identify those who had received pericranial flap lining and these were reviewed for outcomes and complications.
RESULTS: 66 patients who had received second stage reconstruction were identified of these 18 patients had received paramedian forehead flap nasal reconstruction with pericranial flap for reconstruction of the inner lining.
There were no immediate post-operative complications related to the pericranial flap lining. Two patients had minor post-operative complications at other sites. One patient suffered major reconstructive failure post radiation, two patients had partial reconstructive failure following radiation. Two patients had minor side effects post radiation and one had persistent stenosis following surgery.
CONCLUSIONS: The pericranial flap is a reliable flap for inner lining of the paramedian forehead flap in nasal reconstruction. It is easily accessible and particularly useful in resections which leave limited mucosal options.
Care, R. Christchurch Hospital, Christchurch, New Zealand
Lewis, T. Dallhousie University, Halifax, Canada
Taylor, S.M. Dallhousie University, Halifax, Canada
INTRODUCTION: Effective nasal reconstruction requires a three layer closure of skin, cartilage and mucosa. Skin reconstruction commonly utilises the paramedian forehead flap; reconstruction of the inner lining can be challenging. Multiple flaps have been described including the pericranial flap.
AIMS: Here we present a surgical overview of the procedure and a review of a single surgeon experience of the pericranial flap for inner lining for nasal reconstruction.
METHODS: A search of the patient database was performed using the billing code for the second stage nasal reconstruction from its introduction in 2007 – present; identifying patients who had received paramedian forehead flaps. A retrospective chart review of these patients was then performed to identify those who had received pericranial flap lining and these were reviewed for outcomes and complications.
RESULTS: 66 patients who had received second stage reconstruction were identified of these 18 patients had received paramedian forehead flap nasal reconstruction with pericranial flap for reconstruction of the inner lining.
There were no immediate post-operative complications related to the pericranial flap lining. Two patients had minor post-operative complications at other sites. One patient suffered major reconstructive failure post radiation, two patients had partial reconstructive failure following radiation. Two patients had minor side effects post radiation and one had persistent stenosis following surgery.
CONCLUSIONS: The pericranial flap is a reliable flap for inner lining of the paramedian forehead flap in nasal reconstruction. It is easily accessible and particularly useful in resections which leave limited mucosal options.