title: A new method for total nasal reconstruction. The trapezius myocutaneous island "paddle' flap.
abstract: Surgical reconstruction of the total rhinectomy defect presents unique difficulties for both the surgeon and the patient. The forehead flap provides an excellent color match and two-stage reconstruction. However, frequently, flap delay is needed, there may be insufficient cutaneous tissue available, and, most important, a secondary residual facial deformity is created. The tube abdominal flap technique of total nasal reconstruction provides adequate tissue and a hidden scar but gives a poor facial color match, offers multiple operative stages, and can severely debilitate the patient's shoulder from prolonged immobilization. This article outlines a new method of total nasal reconstruction using a trapezius myocutaneous island "paddle" flap. This flap provides abundant cutaneous tissue without need for delay, offers an excellent color match, requires a two-stage operation, and uses a hidden donor site. No immobilization is needed in the transfer of this regional flap to the face and, thus, would be of particular usefulness in the geriatric patient.
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D009334:Neck Muscles / Q000601:surgery; D009667:Nose Deformities, Acquired / Q000601:surgery*; D009669:Nose Neoplasms / Q000601:surgery; D012225:Rhinoplasty / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery; D013524:Surgical Flaps