Evaluation of the success of reconstruction of large lateral nasal defect using two paramedial forehead flaps modalities

In this paper, we aimed to present our experience using the paramedial frontal flap in the reconstruction of a complete heminasal defec resulting from the ablation of residual and recurrent skin tumours. We used two modalities. In first one, we folded the flaps, and in the other, we supplemented the reconstruction with an intranasal septal flap, as a support and replacement for the mucosa. We evaluated the achieved functional and aesthetic results, as assessed by the patients themselves and by independent physicians. We included a total of nine patients divided into two groups. All patients had three or more comorbidities, they were active or former smokers, and were aged 62 to 81 years. All flaps were formed contralateral to the defect and transferred in full thickness. We did not have complications, necrosis, haemorrhage, seroma, or infection in any of our cases. Patients and physicians rated the combined reconstruction method more favourably than the flap folding method. The paramedial frontal flap is a powerful method for reconstructing large nasal defects regardless of its modality. The application of the intranasal septal flap in two stages achieves an almost original nasal shape, while for an identical result with the flap folding modality, a multi-stage procedure is required, which depends on the patient’s decision and consent.