Videos of Surgical Procedures in Dermatology
Turnover Flap of the Nasal Dorsum Combined With a Rotation Advancement Flap to Reconstruct a Full-Thickness Defect of the Nasal Tip and Wall
Colgajo combinado invertido de dorso nasal y de avance-rotación para reparación de defecto de espesor total en punta y pared lateral nasal
M. Azcona Rodríguez
, L. Loidi Pascual, J. Aróstegui Aguilar, M.E. Iglesias
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Servicio de Dermatología del Complejo Hospitalario de Navarra, Pamplona, Navarra, España
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Azcona Rodríguez, L. Loidi Pascual, J. Aróstegui Aguilar, M.E. Iglesias" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Azcona Rodríguez" "email" => array:1 [ 0 => "maialen.azcona.rodriguez@navarra.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Loidi Pascual" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Aróstegui Aguilar" ] 3 => array:2 [ "nombre" => "M.E." "apellidos" => "Iglesias" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología del Complejo Hospitalario de Navarra, Pamplona, Navarra, España" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Colgajo combinado invertido de dorso nasal y de avance-rotación para reparación de defecto de espesor total en punta y pared lateral nasal" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Carcinomas on the nasal pyramid are very frequent, and reconstruction of this area is a surgical challenge, not only because of the major esthetic impact of this facial subunit but also because it is important to maintain functionality. Several procedures have been described for the reconstruction of the surgical defects in this site<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and there are 3 fundamental requirements to obtain a good esthetic outcome.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> First, it is important to determine the characteristics of the cutaneous defect, that is, its site, extension, and depth. Second, reconstruction of the defect should aim to use skin as similar as possible to the excised skin. Finally, it should be remembered that the esthetic subunits of the nose (nasal dorsum, nasal walls, nasal alae, triangular cartilage, tip of the nose, and columella) should be left intact.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We describe the surgical technique and reconstruction performed in an 84-year-old man who had undergone an intervention for solid, invasive, ulcerated basal cell carcinoma in the right nasal wall. The surgical defect was initially reconstructed with a spiral flap, but the pathology report showed involvement of the lateral and deep margins of the resection, so a second full-thickness resection was considered to ensure an optimal oncological outcome.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Description of the Technique</span><p id="par0015" class="elsevierStylePara elsevierViewall">Under local anesthetic, full-thickness excision of the tissue of the initial wound was performed. This included cartilage and mucosa, to create a circular defect of approximately 14<span class="elsevierStyleHsp" style=""></span>mm in diameter at the intersection between the tip of the nose with the ala and the right nasal wall, approximately 5<span class="elsevierStyleHsp" style=""></span>mm from the free border. In the histological study, all surgical borders were tumor free. A crescentic nasojugal turnover flap with an upper pedicle was designed.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This is a modification of the horizontal <span class="elsevierStyleItalic">J</span> rotation flap.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> A line was traced from the upper part of the defect, continuing in an arched form above the nasal ala until reaching the alar crease and extending to where the nasal ala joins the upper lip. A halfmoon discharge was designed in the alar crease to facilitate advancement from the cheek. For better advancement of the flap and to avoid dog ear formation, it was necessary to cut a discharge triangle in the upper-lateral area of the defect, from the base of the defect and the tip towards the nasal wall.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In our case, this triangle was used as a turnover flap,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> to reconstruct the mucosal face of the defect created. A base pedicle was cut proximal to the surgical defect to act as a pivot to turn over the flap. After suturing to the nasal cartilage with resorbable 3/0 stitches, the crescentic nasojugal flap was detached, leaving plenty of margin, to reach the limit between the nose and the cheek. Submuscular dissection was performed, just above the fascia that encase the perichondrium.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In our patient, we found that the flap moved easily to completely cover the defect without resorting to the previously designed discharge halfmoon in the alar crease. The flap was sutured with loose silk 3/0 stitches.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Indications and Contraindications for the Technique</span><p id="par0030" class="elsevierStylePara elsevierViewall">The indications for this combination of flaps are the same as those for the crescentic nasojugal flap (defects on the tip of the nose not more than 20<span class="elsevierStyleHsp" style=""></span>mm in the medial or paramedial area<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>) when the defect is full thickness. The defect should be at a reasonably safe distance from the free border of the nasal ala.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Complications</span><p id="par0035" class="elsevierStylePara elsevierViewall">The patient had a satisfactory postoperative outcome, with daily dressing changes. The suture was removed after 7 days. The outcome of the turnover flap was very good. In the area of the tip of the nose, the crescentic flap led to limited surface necrosis which resolved satisfactorily with local dressing changes in a few days.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="par0040" class="elsevierStylePara elsevierViewall">We describe a case in which we use a combination of 2 flaps. This approach could be useful to resolve full-thickness defects located on the tip of the nose.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Full-thickness excision ensures a good oncological outcome, and this is the primary objective of oncological surgery.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The crescentic nasojugal flap offers a solution for reconstruction of defects of the tip of the nose with a very good esthetic outcome as the reconstruction is performed with skin with very similar characteristics to the resected skin, and the incisions are hidden in the natural folds of the nose. In addition, this is a safe flap as it has a very broad pedicle that ensures its viability.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Of note is that this combination of flaps takes full advantage of the Burow triangle in the upper part of the defect as the donor area for reconstruction of the mucosal face of the defect created.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Description of the Technique" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Indications and Contraindications for the Technique" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Complications" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-08-11" "fechaAceptado" => "2019-10-05" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0065" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0035" ] ] ] ] "multimedia" => array:1 [ 0 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 21972348 "Video" => array:2 [ "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Techniques in nasal tip reconstructive surgery after surgical oncology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.G. Pérez Paredes" 1 => "B. González Sixto" 2 => "L.M. Valladares Narvanes" 3 => "M.A. Rodríguez Prieto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Piel" "fecha" => "2013" "volumen" => "28" "numero" => "4347" "paginaInicial" => "428" "paginaFinal" => "435" "itemHostRev" => array:3 [ "pii" => "S2213260020301107" "estado" => "S300" "issn" => "22132600" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Crescentic Nasojugal Flap for Nasal Tip Reconstruction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Smadja" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1524-4725.2007.33012.x" "Revista" => array:7 [ "tituloSerie" => "Dermatol Surg" "fecha" => "2007" "volumen" => "33" "numero" => "1" "paginaInicial" => "76" "paginaFinal" => "81" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17214683" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nasal Tip Reconstruction: The Horizontal ‘J’ Rotation Flap Using Skin from the Lower Lateral Bridge and Cheek" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.N. Snow" 1 => "F.E. Mohs" 2 => "D.C. Olansky" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1524-4725.1990.tb00111.x" "Revista" => array:7 [ "tituloSerie" => "J Dermatol Surg Oncol" "fecha" => "1990" "volumen" => "16" "numero" => "8" "paginaInicial" => "727" "paginaFinal" => "732" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2394876" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reconstruction of the ala nasi using a malar turnover island pedicle flap" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Godoy-Gijón" 1 => "L. Palacio-Aller" 2 => "M. González-Sabin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2014.07.001" "Revista" => array:7 [ "tituloSerie" => "Actas Dermosifiliogr." "fecha" => "2015" "volumen" => "106" "numero" => "April (3)" "paginaInicial" => "233" "paginaFinal" => "235" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25267566" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011100000009/v1_202012010756/S1578219020302742/v1_202012010756/en/main.assets" "Apartado" => array:4 [ "identificador" => "6209" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Videos of Surgical Procedures in Dermatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011100000009/v1_202012010756/S1578219020302742/v1_202012010756/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020302742?idApp=UINPBA000044" ]
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| 2023 Octubre | 91 | 31 | 122 |
| 2023 Septiembre | 56 | 29 | 85 |
| 2023 Agosto | 52 | 25 | 77 |
| 2023 Julio | 63 | 42 | 105 |
| 2023 Junio | 66 | 21 | 87 |
| 2023 Mayo | 77 | 19 | 96 |
| 2023 Abril | 61 | 37 | 98 |
| 2023 Marzo | 74 | 34 | 108 |
| 2023 Febrero | 47 | 20 | 67 |
| 2023 Enero | 73 | 45 | 118 |
| 2022 Diciembre | 62 | 39 | 101 |
| 2022 Noviembre | 34 | 26 | 60 |
| 2022 Octubre | 31 | 16 | 47 |
| 2022 Septiembre | 27 | 32 | 59 |
| 2022 Agosto | 25 | 39 | 64 |
| 2022 Julio | 24 | 55 | 79 |
| 2022 Junio | 33 | 54 | 87 |
| 2022 Mayo | 61 | 61 | 122 |
| 2022 Abril | 63 | 41 | 104 |
| 2022 Marzo | 72 | 74 | 146 |
| 2022 Febrero | 67 | 47 | 114 |
| 2022 Enero | 80 | 53 | 133 |
| 2021 Diciembre | 61 | 57 | 118 |
| 2021 Noviembre | 71 | 64 | 135 |
| 2021 Octubre | 71 | 76 | 147 |
| 2021 Septiembre | 62 | 65 | 127 |
| 2021 Agosto | 93 | 61 | 154 |
| 2021 Julio | 44 | 48 | 92 |
| 2021 Junio | 72 | 51 | 123 |
| 2021 Mayo | 57 | 64 | 121 |
| 2021 Abril | 197 | 116 | 313 |
| 2021 Marzo | 114 | 55 | 169 |
| 2021 Febrero | 88 | 60 | 148 |
| 2021 Enero | 69 | 52 | 121 |
| 2020 Diciembre | 75 | 50 | 125 |
| 2020 Noviembre | 21 | 13 | 34 |
| 2020 Octubre | 14 | 8 | 22 |
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