Nasal defects : Aetiology and reconstruction patterns

Abstract

Background: Nose is a prominent and defining feature of the face. Nasal reconstruction was among the first plastic surgical procedures performed, earliest being performed using local flaps taken from the cheek by Sushruta (600BC).

Objectives:

1. To study the aetiology and patterns of various nasal defects.
2. To study various reconstructive procedures used for 

Study design and methods: This study was conducted in the Department of Plastic and Reconstructive Surgery, SKIMS from January 2015 to August 2017 (retrospectively) and prospectively from September  2017 to July 2019. The aetiology and characteristics of the nasal defect was analysed. Each patient was planned and treated by the best available reconstructive procedure and any complications were assessed and managed in the postoperative period.

Participants: All patients with nasal defects admitted in our department.

Results: About 75% of patients were in the middle and elder age group. Male: female ratio was 1:1. The aetiology of nasal defects in the majority of cases was trauma (45%) and tumours (45%). Various reconstructive procedures included split-thickness skin graft in 38.7%, full-thickness skin graft in  16.3%, forehead flap in 14.2% and others. Among complications, one patient suffered graft loss and one suffered flap necrosis.

Conclusion: Nasal defects occur with equal frequency in both genders with trauma and tumours being the most common etiological factors. STSG has good results in partial-thickness defects.

Implications: The management of nasal defects is influenced by the size and location of the defect as well as the availability and condition of adjacent skin. These factors dictate the surgeon regarding the most suitable reconstructive procedure and ultimately, the reconstructive plan offered to the patient is dictated by the surgeon’s preference, comfort, and ability.