The forehead flap for nasal reconstruction.
BACKGROUND
Reconstruction of extensive nasal defects often represents a significant challenge owing to several unique qualities of the nose, such as complex topography, mobile free margins, and multiple nasal subunits. Furthermore, loss of internal nasal lining and/or structural skeletal support may be present following removal of extensive skin cancers.


OBJECTIVE
To describe our experience with the use of forehead flap reconstruction for extensive nasal defects.


METHODS
Retrospective case series.


METHODS
Academic health care hospital system.


METHODS
One hundred forty-seven patients with extensive nasal defects repaired with a forehead flap.


METHODS
The functional and aesthetic results were assessed. The characteristics of defects repaired with the forehead flap and the need for lining and/or cartilage were examined.


RESULTS
The forehead flap was used to repair 147 nasal defects after Mohs excision of nonmelanoma skin cancer. Full-thickness skin was lost in all cases, structural skeletal support in 68 cases (46%), and internal mucosal lining in 45 cases (31%). Our experience and surgical technique using the forehead flap are described.


CONCLUSIONS
The forehead flap represents one of the best methods for repair of extensive nasal defects. Near-normal functional and cosmetic results can be achieved.
Boyd
C M
CM
Department of Otorhinolaryngology, University of Michigan, 1904 Taubman Center, Box 0312, Ann Arbor, MI 48109-0312, USA. cmboydmd@umich.edu
Baker
S R
SR
Fader
D J
DJ
Wang
T S
TS
Johnson
T M
TM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005546:Forehead; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009669:Nose Neoplasms / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016038:Skin Transplantation; D013524:Surgical Flaps; D016896:Treatment Outcome