title: Single-stage reconstruction of skin-involving nasal paraffinoma with pericraniosubgaleal flap.
abstract: BACKGROUND
  The removal of a paraffinoma over the nasal bridge may result in thinning and even loss of involved skin as well as a saddle nose deformity. For nasal reconstruction, a variety of techniques using a free graft of autogenous tissue such as fascia, dermofat, or cartilage have been used, either in immediate, single-stage or in delayed, multiphase treatment. However, such reconstructions can be challenging largely due to absorption of the grafted tissue and poor blood supply to the surrounding nasal tissue infiltrated with paraffin. This article reports the successful clinical outcomes of immediate, single-stage reconstructions by wrapping a pericraniosubgaleal flap over the nasal implant after removing a paraffinoma.
  
  
  METHODS
  Eleven patients with a paraffinoma showing a palpable lump, redness, or telangiectasia over the nasal skin were treated between November 1998 and March 2011. The mean follow-up period was 20.1 months. As much of the paraffinoma as possible was removed via a bidirectional approach (open rhinoplasty and frontal hairline incision), and the resulting deformity was reconstructed simultaneously using a pericraniosubgaleal flap and turning it over the sculpted nasal implant (ePTFE; GORE-TEX(®) in nine cases and silicone in two cases).
  
  
  RESULTS
  Nine patients (81.8%) were treated successfully without complications and were satisfied with their results. However, the other two patients complained of incomplete removal of the paraffinoma requiring additional removal. Telangiectasia over the nose improved in four out of six patients after surgery.
  
  
  CONCLUSIONS
  Nasal reconstruction using a pericraniosubgaleal flap is one of the most reliable surgical options for treating skin-involving nasal paraffinomas. The advantage of such a method is that a well-vascularized and durable flap, which is resistant to infection, is wrapped over the sculpted nasal implant in a single step. It also reinforces the thinned skin, which makes it easier to form various shapes, producing excellent cosmetic results. Finally, it can also serve as a tolerable graft bed in the case of overlying skin loss.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyung Hee University, #1 Hoeki-dong, Dongdaemun-ku, Seoul, 130-702, Korea. bepos@hanmail.net
authors.forename: Seung-Il
authors.initials: SI
authors.lastname: Chung
authors.forename: Young-Cheun
authors.initials: YC
authors.lastname: You
authors.forename: Ki-Yup
authors.initials: KY
authors.lastname: Kim
authors.forename: Won-Yong
authors.initials: WY
authors.lastname: Yang
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kwon
authors.forename: Sang-Yoon
authors.initials: SY
authors.lastname: Kang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D009668:Nose Diseases / Q000601:surgery*; D010232:Paraffin / Q000008:administration & dosage*; D019736:Prostheses and Implants / Q000009:adverse effects*; D011781:Quackery; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply
chemical_list: D010232:Paraffin