title: Reconstruction of Nasal Cleft Deformities Using Expanded Forehead Flaps: A Case Series.
abstract: BACKGROUND
  Reconstruction of the nasal clefts is a challenging task considering the nasal anatomic complexity and their possible association with craniofacial defects. The reconstruction of these defects needs extensive amounts of soft tissue that warrant the use of forehead flaps. Often presence of cranial defects and low hairline compromise the amount of tissue available for reconstruction warrenting tissue expansion.
  
  
  OBJECTIVE
  To evaluate the efficacy of tissue expansion in reconstruction of congenital nasal clefts.
  
  
  METHODS
  9 patients with congenital nasal clefts involving multiple sub units were taken up for nasal reconstruction with expanded forehead flaps. The average amount of expansion needed was 200 ml. The reconstruction was performed in 3 stages.
  
  
  RESULTS
  Expanded forehead flaps proved to be best modality for reconstruction providing the skin cover needed for ala, columella and dorsum with minimal scarring at the donor site.
  
  
  CONCLUSIONS
  Expansion of the forehead flap is a viable option for multiple sub unit reconstruction in congenital nasal cleft deformities.
authors.affiliation: Meenakshi Cleft and Craniofacial Centre, Chennai, Tamilnadu India.
authors.forename: Manikandhan
authors.initials: M
authors.lastname: Ramanathan
authors.affiliation: Meenakshi Cleft and Craniofacial Centre, Chennai, Tamilnadu India.
authors.forename: Pendem
authors.initials: P
authors.lastname: Sneha
authors.affiliation: Meenakshi Ammal Dental College and Hospital, Chennai, Tamilnadu India.
authors.forename: Ananthnarayanan
authors.initials: A
authors.lastname: Parameswaran
authors.affiliation: Meenakshi Ammal Dental College and Hospital, Chennai, Tamilnadu India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Jayakumar
authors.affiliation: Cleft Children International, Zurich, Switzerland.
authors.forename: Hermann F
authors.initials: HF
authors.lastname: Sailer
keywords: Forehead flaps; Nasal cleft deformities; Tessier facial clefts; Tissue expansion