title: The V-Y island dorsal nasal flap for reconstruction of the nasal tip.
abstract: The dorsal nasal flap and its modifications have proved reliable in the coverage of defects on or adjacent to the tip of the nose. However, the problems inherent in the nature of the flap are limited rotational movement afforded by the pedicle, visible scars crossing the dorsum and the natural concavity of the alar crease, skin thickness discrepancy between the flap and the skin, and dog-ear deformity created by the rotation. The purpose of this study was to design a new modification of the dorsal nasal flap, in the highlight of a cadaveric study, that can overcome the traditional drawbacks. Ten adult human cadavers were used to study the vascular basis of the flap and to simulate application of the flap. Cadaveric dissections demonstrated that a skin island over the nasal dorsum and glabellar area can be elevated safely based on a dual axial supply (i.e., the terminal branches of the angular artery and vein bilaterally), and can be advanced easily in a V-Y manner to cover the nasal tip defect. The result obtained in the clinical case showed that the V-Y island dorsal nasal flap provided a sizable amount of skin with more appropriate texture and color for coverage of the nasal tip defect without tension or secondary deformity.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 4-24-1 Kamisoshigaya (C-213), Setagaya-ku, Tokyo 157-0065, Japan.
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Erçöçen
authors.forename: Zeki
authors.initials: Z
authors.lastname: Can
authors.forename: Murat
authors.initials: M
authors.lastname: Emiroğlu
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Tekdemir
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009669:Nose Neoplasms / Q000601:surgery; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply