Reconstruction of Full Thickness Ala Defect with Nasolabial Fold and Septal Mucosal Hinge Flap

Abstract

Reconstruction of a full-thickness alar defect requires independent blood supplies tothe inner and outer surfaces. Because of this, secondary operations are commonlyneeded for the division of skin flap from its origin. Here, we report a single-stage reconstructionof full-thickness alar defect, which was made possible by the use of a nasolabialisland flap and septal mucosal hinge flap. A 49-year-old female had presented witha squamous cell carcinoma of the right ala which was invading through the mucosa. The lesion was excised with a 5-mm free margin through the full-thickness of ala. Thelining and cartilage was restored using a septal mucosa hinge flap and a conchal cartilagefrom the ipsilateral ear. The superficial surface was covered with a nasolabialisland flap based on a perforator from the angular artery. The three separate tissuelayers were reconstructed as a single subunit, and no secondary operations were necessary. Single-stage reconstruction of the alar subunit was made possible by the useof a nasolabial island flap and septal mucosal hinge flap. Further studies are needed tocompare long-term outcomes following single-stage and multi-stage reconstructions