Background: Aesthetic nasal reconstruction always offers
a challenge to the plastic surgeon, especially with large defects
of more than 2cm. The modification of the dorsal nasal flap < br />might offer a superior alternative for the forehead flap.
Objective: In this study, we aimed to assess the outcomes
of the dorsal nasal flap in the reconstruction of large nasal defects
beyond the original indications.
Patients and Methods: We have prospectively studied 12
patients older than 40 years with skin-only nasal defects occupying
the distal 2/3 of the nose, larger than 2cm in size, and/
or located less than 5mm from the alar rim. A modified dorsal
nasal flap was done in all the cases.
Results: The mean age of patients was 59.33±7.01 years.
The mean dimensions of lesions were 25±2.32mm with a mean
distance of 2.57±1.62mm from the alar rim. Regarding Aesthetic
outcomes, patients and surgeons expressed excellent
color match in 91.7% of patients. As for alar retraction, patients
and doctors expressed good to excellent results in 83%
of patients. Additionally, patients and physicians reported
good to excellent nostril shape in 83.3% and 66.6% of patients
respectively. Regarding the flap thickness, patients and doctors
expressed good to excellent results in 91.6% and 75% of patients
respectively.
Conclusion: The dorsal nasal flap seems to be more applicable
than classically reported. Defects up to 29mm in size
and/or defects located 2mm from the alar rim result in acceptable
to excellent aesthetic outcomes when the modified dorsal
nasal flap applied in this work is used. Our modified dorsal
nasal flap resulted in excellent outcomes in 4 cases, accepted
outcomes in 5 cases, and unfavorable outcomes in 3 cases.