title: The epithelial 'turn-in' flap in nasal reconstruction.
abstract: OBJECTIVE
  To evaluate the epithelial "turn-in" flap for reconstruction of the internal lining in full-thickness nasal defects. Highlighted are its indications, technique, complications, and clinical success, particularly in comparison with the other common modalities for reconstructing this nasal lining. Also, to determine how the random flap withstands vigorous thinning.
  
  
  METHODS
  A retrospective chart review and clinical follow-up of all patients with full-thickness nasal defects of the nose.
  
  
  METHODS
  The patient pool comes from a tertiary care center that draws from a large geographic area in the Northwest. Both urban and rural demographics are represented.
  
  
  METHODS
  Fifty-six patients with large full-thickness nasal defects were reviewed, 18 of which were reconstructed with the epithelial turn-in flap. The causes of the original defect were varied.
  
  
  METHODS
  Full-thickness nasal defects were reconstructed in a layered fashion. The turn-in flaps were aggressively thinned to the subdermal plane to minimize flap bulk and airway compromise.
  
  
  METHODS
  Attention was made to the size and precise location of the defect, the mode of reconstruction, flap viability, and nasal function.
  
  
  RESULTS
  Eighteen patients had turn-in flaps for reconstruction of the internal lining. Sixteen patients (89%) had 100% viability of their flaps. Seventeen (94%) reported normal nasal function.
  
  
  CONCLUSIONS
  The epithelial turn-in flap is a robust flap that provides dependable and functional results. One of the major advantages of this flap over other methods is that often there is no donor site morbidity. For many select defects, the turn-in flap remains a method of choice for repair of the internal lining.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Park
authors.forename: T A
authors.initials: TA
authors.lastname: Cook
authors.forename: T D
authors.initials: TD
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery; D002675:Child, Preschool; D004848:Epithelium / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009297:Nasal Mucosa / Q000473:pathology / Q000601:surgery; D009666:Nose / Q000503:physiopathology / Q000601:surgery*; D009668:Nose Diseases / Q000473:pathology / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery; D012119:Respiration; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods* / Q000473:pathology; D013524:Surgical Flaps / Q000379:methods* / Q000473:pathology