Nasal Reconstruction Using Free TAPAS Flap for Internal Lining Restoration After Hemi-Rhinectomy : A Case report

Nasal reconstruction represents a challenge for the 3-dimensional structure with a 3-layer structure. Internal lining remains the most demanding tissue to be reconstructed. We utilized the free temporal artery posterior auricular skin (TAPAS) flap for reconstructing the internal nasal lining of the vault and septum of a single coana following hemi-rhinectomy. A case study of a 79-years-old male patient with a malignant melanoma illustrates the effectiveness of this approach. A free TAPAS flap was harvested to restore the lining together with a homolateral forehead flap for the external skin resurfacing. Cartilage was raised from the septum and auricular concha, to recreate the nose framework. Although its relevance, lining reconstruction remains underestimated, especially when approaching to hemi-nasal defects. Our technique allows for one-stage reconstruction, through the usage of TAPAS flap, a thin and pliable tissue with a negligible aesthetic impact. The features of TAPAS flap match the necessities of lining reconstruction of complex nasal defects.