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Paramedian Forehead Flap Case Example

last modified on: Mon, 10/01/2018 - 08:58

See: Paramedian Forehead Flap

See also: Facial Plastics

Cases provided by:  Dr. Douglas K Henstrom, Director of University of Iowa Facial Plastics and Reconstructive Surgery, Department of Otolaryngology

Case #1-Intraop Paramedian Forehead Flap

Case #2 Nasal Reconstruction using septal hinge flap for internal lining, conchal cartilage graft for support, and paramedian forehead flap for external covering

  1. Reconstruction following MOH's surgery for superficial nasal/ala cancer
  2. Completed case from preop eval to 5 months postop. Patient had previous attempted ipsilateral paramedian forehead flap done elsewhere, which had failed. Forehead allowed to granulate and heal secondarily to completion.

Case #1-Intraop Paramedian Forehead Flap

 
Lateral nasal wall defect
Defect Template
Superior view of defect
Forehead Flap incised and raised
Flap Placement planning (Lateral view)
Flap Inset (Superior view)
Forehead donor site closed
Completed Lateral View (xeroform guaze wrapped around pedicle)
     
Completed Basal View
     
  1.  
  2. Completed case from preop eval to 5 months postop. Patient had previous attempted ipsilateral paramedian forehead flap done elsewhere, which had failed. Forehead allowed to granulate and heal secondarily to completion.

Case #2 Nasal Reconstruction using septal hinge flap for internal lining, conchal cartilage graft for support, and paramedian forehead flap for external covering

Preop Anterior view
Preop Close up lateral view
Preop Basal view
1st Stage Intraop-Septal Hinge Flap for internal lining
1st Stage Intraop-Septal Hinge flap sutured in place
1st Stage Intraop-Basal view of Septal Hinge Flap
1st Stage Intraop-Conchal Cartilage graft-Lateral view
1st Stage Intraop-Conchal Cartilage graft-Basal view
1st Stage Intraop-Conchal Cartilage graft-Superior view
1st Stage Intraop-Forehead flap template
1st Stage Intraop-Contralateral forehead flap designed (previous failed forehead flap visualized)
1st Stage Intraop-Forehead flap elevated and thinned distally
1st Stage Intraop-Forehead flap inset-Superior view
1st Stage Intraop-Forehead flap inset-Lateral view
1st Stage Intraop-Forehead flap inset-Basal view
3 weeks post 1st stage-Anterior view
3 weeks post 1st stage--L Oblique view
3 weeks post 1st stage-R Oblique view
3 weeks post 1st stage-Basal view
Intraop 2nd stage-Flap inset into nose-Superior view

 

Intraop 2nd stage-Flap inset into nose-Lateral view
Intraop 2nd stage-Flap inset into nose-Anterior view
Intraop 2nd stage-Flap inset into nose-Basal view
5 month postop-Anterior view
   
5 month postop-Lateral view
5 month postop--Basal view