DOI QR코드

DOI QR Code

Alar crease as a donor site for the extension limb of modified nasolabial V-Y advancement flap

  • Yooseok Ha (Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital) ;
  • Yunsung Park (Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital) ;
  • Hyunwoo Kyung (Department of Plastic and Reconstructive Surgery, Chungnam National University Sejong Hospital) ;
  • Sang-Ha Oh (Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital)
  • 투고 : 2023.08.23
  • 심사 : 2023.12.20
  • 발행 : 2023.12.20

초록

Background: The traditional nasolabial V-Y advancement flap is widely used for midface reconstruction, particularly for the lower third of the nose and upper lip, as its color and texture are similar to these areas. However, it provides insufficient tissue to cover large defects and cannot restore the nasal convexity, nasal ala, and adjacent tissues. The purpose of this study is to investigate the modified nasolabial V-Y advancement flap with extension limbs the along alar crease for the reconstruction of complex midface defects. Methods: A retrospective analysis of 18 patients, who underwent reconstruction with the modified nasolabial V-Y advancement flap, was performed between September 2014 and December 2022. An extension limb was added along the alar crease, adjacent to the defect area, and was hinged down as a transposition flap at the end of the advancement flap. Results: The extension limb along the alar crease successfully covered large and complicated defects, including those of the ala, the alar rim, the alar base, the nostrils, and the upper lip, with minor complications. Conclusion: The alar crease is a good donor site for the reconstruction of large and complex nasal and upper lip defects.

키워드

과제정보

This work was supported by the Research fund of Chungnam National University and the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant no.: HI20C2088).

참고문헌

  1. Kim MJ, Lim H, Park DH. Current strategies for aesthetic soft tissue refinement in nasal reconstruction. Arch Craniofac Surg 2022;23:95-102. https://doi.org/10.7181/acfs.2022.00689
  2. Luce EA. Upper lip reconstruction. Plast Reconstr Surg 2017; 140:999-1007. https://doi.org/10.1097/PRS.0000000000003400
  3. Lee DW, Ryu HR, Choi HJ, Kim JH. One-stage reconstruction of full-thickness alar defects with a folded nasolabial island flap. Arch Craniofac Surg 2021;22:296-302. https://doi.org/10.7181/acfs.2021.00339
  4. Yildirim S, Akoz T, Akan Md, Avci G. Nasolabial V-Y advancement for closure of the midface defects. Dermatol Surg 2001;27: 656-8. https://doi.org/10.1046/j.1524-4725.2001.00346.x
  5. Li JH, Xing X, Liu HY, Li P, Xu J. Subcutaneous island pedicle flap: variations and versatility for facial reconstruction. Ann Plast Surg 2006;57:255-9.
  6. Oh SK, Song B, Lee WS, Oh SH. Repair of a nasal ala defect involving the alar rim and nostril floor. Dermatol Surg 2023;49: 411-3. https://doi.org/10.1097/DSS.0000000000003596
  7. Chun K, Lee CL, Yang HJ, Oh SH. Repair of a large upper lip defect involving the alar base and nostril floor. Dermatol Surg 2021;47:1634-5. https://doi.org/10.1097/DSS.0000000000003231
  8. Pribaz JJ, Chester CH, Barrall DT. The extended V-Y flap. Plast Reconstr Surg 1992;90:275-80. https://doi.org/10.1097/00006534-199290020-00017
  9. Chan ST. A technique of undermining a V-Y subcutaneous island flap to maximise advancement. Br J Plast Surg 1988;41:62-7. https://doi.org/10.1016/0007-1226(88)90146-4
  10. Zitelli JA, Brodland DG. A regional approach to reconstruction of the upper lip. J Dermatol Surg Oncol 1991;17:143-8. https://doi.org/10.1111/j.1524-4725.1991.tb01607.x
  11. Skouge JW. Upper lip repair: the subcutaneous island pedicle flap. J Dermatol Surg Oncol 1990;16:63-8. https://doi.org/10.1111/j.1524-4725.1990.tb00010.x
  12. Ray TL, Weinberger CH, Lee PK. Closure of large surgical defects on the cutaneous upper lip using an island pedicle flap. Dermatol Surg 2010;36:931-4. https://doi.org/10.1111/j.1524-4725.2010.01570.x
  13. Chen C, Patel R, Chi J. Comprehensive algorithm for nasal ala reconstruction: utility of the auricular composite graft. Surg J (N Y) 2018;4:e55-61. https://doi.org/10.1055/s-0038-1639581