Forehead Flap in Coverage of Nasal Defects: Our Experience

Abstract

Background: Coverage of post-traumatic or post-oncosurgical nasal defects is a very challenging procedure. Small nasal defects may be covered by skin grafts or small local flaps while larger nasal defects require more complex flap coverage techniques as using tissue expanders, prefabricated flaps or free flaps. The forehead flap has been used for centuries and remains a workhorse flap for reconstruction of large and complex nasal defects. Aim: evaluate the feasibility and versatility of forehead flap for resurfacing nasal defects. Materials and Methods: 12 patients underwent coverage of nasal defects after trauma or tumor excision using forehead flaps. All flaps needed a second stage for flap separation 3 weeks after the time of operation. The size of the harvested flap, the harvesting time, results of transferred flaps, patient satisfaction and flap-related complications were analyzed. Results: 12 patients (10 males and 2 females) underwent reconstruction of different nasal defects using 12 forehead flaps. The overall complications occurred in 2 patients. The remaining 10 patients showed no complications and passed an uneventful follow-up period. 7 Patients were very satisfied, 4 were satisfied and only one patient was not satisfied as she was 23 years old young female and was subjected to human bite. Follow-up periods ranged from 6 to 12 months. Conclusion: Nasal defects can successfully be managed with the forehead flap. Probably, the flap provides the best result due to the good matching of the skin in terms of color, texture, and thickness. Also, despite the increasing use of free flaps, the forehead flap is still a valid and safe option for nasal defects coverage that allows good aesthetics and functional outcomes.