1 / 15

Jun Yong Lee, M.D., Sung-No Jung, M.D., Ho Kwon, M.D.

One-stage Nasal Reconstruction With Full-thickness Composite Posterior Auricular Artery Perforator Free Flap. Jun Yong Lee, M.D., Sung-No Jung, M.D., Ho Kwon, M.D. Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine,

evonne
Download Presentation

Jun Yong Lee, M.D., Sung-No Jung, M.D., Ho Kwon, M.D.

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. One-stage Nasal Reconstruction With Full-thickness Composite Posterior Auricular Artery Perforator Free Flap Jun Yong Lee, M.D., Sung-No Jung, M.D., Ho Kwon, M.D. Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University, Republic of Korea

  2. Disclosure • Nothing to disclose.

  3. Background • Large full thickness defects of the nasal region including zones II and III • Diverse methods are introduced • Stepwise operations are required • Can not be used when the patients can not be followed up • e.g. foreigner

  4. Purpose • To report a one-stage reconstruction method for nasal composite tissue defects using full-thickness composite posterior auricular artery perforator free flaps.

  5. Presentation of the case • M/25 • Nasal composite tissue defect due to human bite • No amputee • Foreigner – scheduled to leave three months later

  6. Operative planning • Wedge shape full-thickness defect • External skin: 2.5 x 2.5cm • Nasal lining: 0.5 x 1cm • One-stage reconstruction • Should be treated within three months

  7. Operative planning • Posterior auricular artery perforator free flap • Full thickness through and through harvest (No report up to date) • Conchal skin → Nasal lining • Conchal cartilage → Alar cartilage • Posterior auricular skin → External nasal skin

  8. Posterior auricular Artery perforator Conchal skin & Conchal cartilage

  9. Anastomosis with lateral nasal artery • No venous anastomosis → systemic heparinization for a salvation of the flap

  10. A: Preoperative view • B: Postoperative 7-day view • C: Postoperative 3-week view • D: Postoperative 10-month view

  11. A: Preoperative CT • B: Postoperative 3-week CT • C: Postoperative 10-month CT ◄ Endoscopic view of nasal lining (POD#3weeks) - Good survival of conchal skin Conchal Skin

  12. Postoperative course • Donor: closed primarily • Minior difference in the auriculocephalic angle • Slight narrowing of the intertragic notch • CT follow-up • Well maintained conchal cartilage • Silicone sheeting for contouring • Started six weeks after surgery

  13. Conclusion • Full-thickness posterior auricular artery perforator free flap can be used in one-stage reconstruction of nasal composite defect with satisfactory results • Full-thickness tissues of the ear can be survived by posterior auricular artery perforator alone • Considered to be another good option for one-stage nasal reconstruction

  14. Thank you for your attention p.s. Fortunately, we can follow-up the patient 10 months after the surgery because he extended his visa for six months.

More Related