Mustardé Flap for Primary Nasal Sidewall Defect post Mohs Micrographic Surgery

Reconstruction Techniques for the Medial Canthus and Lateral Nasal Wall: A Case-Based Learning Approach

Introduction

Reconstruction of the medial canthus and lateral nasal wall poses a significant challenge in dermatologic surgery due to the area's complex, concave, three-dimensional anatomy, and proximity to critical structures like the nasolacrimal system.

Case Presentation

This case-based learning approach details three different techniques on the management of extensive defects involving the medial canthus and lateral nasal wall, focusing on three different surgical techniques: the Mustardé flap, a combination of flaps with a graft, and a supraclavicular skin graft. All three approaches achieved satisfactory clinical and cosmetic outcomes.

Conclusion

Successful reconstruction in this region requires a multidisciplinary approach that carefully integrates facial esthetic units while preserving the functional integrity.

A lower eyelid and cheek defect reconstruction

A 91 years old woman presented with a recurrent cutaneous squamous cell carcinoma (CSCC) involving the right lower eyelid and cheek. Recurrence occurred after one month from an incomplete surgical excision: histology reported a tumor infiltration of the subcutaneous tissue and deep margin. [...]

Locoregional Flaps for the Reconstruction of Midface Skin Defects: A Collection of Key Surgical Techniques

BACKGROUND

The reconstruction of midface skin defects represents a challenge for the head and neck surgeon due to the midface's significant role in defining important facial traits. Due to the high complexity of the midface region, there is no possibility to use one definitive flap for all purposes. For moderate defects, the most common reconstructive techniques are represented by regional flaps. These flaps can be defined as donor tissue with a pedunculated axial blood supply not necessarily adjacent to the defect. The aim of this study is to highlight the more common surgical techniques adopted for midface reconstruction, providing a focus on each technique with its description and indications.

METHODS

A literature review was conducted using PubMed, an international database. The target of the research was to collect at least 10 different surgical techniques.

RESULTS

Twelve different techniques were selected and cataloged. The flaps included were the bilobed flap, rhomboid flap, facial-artery-based flaps (nasolabial flap, island composite nasal flap, retroangular flap), cervicofacial flap, paramedian forehead flap, frontal hairline island flap, keystone flap, Karapandzic flap, Abbè flap, and Mustardè flap.

CONCLUSIONS

The study of the facial subunits, the location and size of the defect, the choice of the appropriate flap, and respect for the vascular pedicles are the key elements for optimal outcomes.