title: Total and subtotal upper eyelid reconstruction with the nasal chondromucosal flap: a 10-year experience.
abstract: BACKGROUND
  The authors review their 10-year experience with the nasal chondromucosal flap for total and subtotal upper eyelid reconstruction.
  
  
  METHODS
  After several modifications, the flap is now designed along the lateral nasal wall and is based on the terminal branch of the dorsal nasal artery, to include the subcutaneous tissues down to the periosteum and the cranial portion of the upper lateral cartilage. A skin graft is applied for cutaneous coverage. The flap can be harvested unilaterally or contralaterally.
  
  
  RESULTS
  Fifteen patients, aged 50 to 75 years, have been operated on with this technique for total or subtotal defects of the upper eyelid since 1993. Follow-up included assessment of position, closure, presence of epiphora, length of palpebral rim, eyelid opening, levator function, aesthetic balance, and donor-site morbidity. The flap result was viable in every patient, without total or partial necrosis. Static parameters were within normal ranges, and 8 to 18 mm of levator function (mean, 13 mm) was achieved.
  
  
  CONCLUSIONS
  Compared with other frequently used techniques, namely, the Cutler-Beard advancement flap and the Mustarde lid switch flap, this procedure is a one-stage operation, does not damage the lower lid, and provides a thin, mobile eyelid with an anatomically complete reconstruction. The nasal chondromucosal flap has thus become the authors' standard for large full-thickness defects of the upper lid.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Rome La Sapienza, Rome, Italy. nicolo.scuderi@uniroma1.it
authors.forename: Nicolò
authors.initials: N
authors.lastname: Scuderi
authors.forename: Diego
authors.initials: D
authors.lastname: Ribuffo
authors.forename: Stefano
authors.initials: S
authors.lastname: Chiummariello
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery*; D005142:Eyelid Neoplasms / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps