Principles of the reconstruction of nasal defects

Abstract

This article describes the principles of reconstruction for nasal tissue defects having a tumoral or traumatic cause, and describes results as they may actually be obtained. A brief historic resume dating back to Indian antiquity and Italian renaissance shows the main steps of reconstruction. The diagnostic approach, resection margins as well as timing of reconstruction are briefly detailed. The reconstruction principles aim to independently restore the three layers of the nasal pyramid, namely mucosa, bony and cartilaginous support, as well as skin coverage. The frontal or Indian flap remains the most widely used, and requires three surgical steps in order to obtain the needed finesse for a natural and almost invisible reconstruction. Some cases of complex reconstructions are shown.