title: Prelaminated fascia lata free flap for large nasal septal defect reconstruction.
abstract: Nasal septal defects can be challenging to repair, given their location, size, and the unique, tri-layered structure of the septum, which includes a thin piece of cartilage positioned between mucosal layers. The report herein presents a case of a 47 year-old woman with a large symptomatic nasal septal perforation, despite saline irrigations and ointment. Placement of a septal button or a traditional surgical approach was not considered because of the extremely large nature of the perforation. We describe the use of a tri-layered fascia lata flap prelaminated with buccal mucosa grafts to successfully repair this complicated defect. Subsequent follow-up visits showed complete repair of the defect and patent nasal passages, without the need for any debulking procedures. Based on these results, we conclude that a prelaminated fascia lata flap is a good reconstructive option for large, complex nasal septal defects, bringing thin, healthy mucosalized tissue to the defect and minimizing future surgical procedures.
authors.affiliation: Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bank
authors.affiliation: The University of Chicago Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Beederman
authors.affiliation: Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Naclerio
authors.affiliation: Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA. Electronic address: lgottlie@surgery.bsd.uchicago.edu.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Gottlieb
mesh_terms: D002356:Cartilage / Q000637:transplantation; D005206:Fascia Lata / Q000637:transplantation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation; D061270:Nasal Septal Perforation / Q000601:surgery*; D009300:Nasal Septum / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps
keywords: Fascia lata; Free flap; Nasal septal defect; Prelamination