Journal of Plastic, Breast & Reconstructive Surgery·تقارير حالات جراحية بمراجعة الأقران ومفتوحة الوصولمراجعة الأقران · وصول مفتوح
Julie Husted Andersen. Case 6 (2023): Nasal reconstruction with bilateral nasolabial flaps. Journal of Plastic, Breast & Reconstructive Surgery. 2023.
وصول مفتوح. © 2023 المؤلف(ون). نُشر بواسطة Journal of Plastic, Breast & Reconstructive Surgery. حقوق الطبع لهذه الحالة مشتركة بين المؤلف(ين) والمجلة؛ ويجوز للمؤلفين إعادة استخدام حالتهم الخاصة للأغراض التعليمية والعروض التقديمية ووسائل التواصل الاجتماعي.
استمر في القراءة
Julie Husted Andersen
75 year old woman with a history of basal cell carcinoma (nBCC) located to the apex of the nose. The first biopsy was made in 2014. Since then the patient suffered a relapse and in september 2022 the excision was made with a surgical margin of 5 mm. The defect was left open until final histology. Histology showed that the tumor was radically excised and now ready for planning of a facial flap.
BeforeAfter75 year old woman with a history of basal cell carcinoma (nBCC) located to the apex of the nose. The first biopsy was made in 2014. Since then the patient suffered a relapse and in september 2022 the excision was made with a surgical margin of 5 mm. The defect was left open until final histology. Histology showed that the tumor was radically excised and now ready for planning of a facial flap.
The surgery was originally planned for excision and use of per-operative freezing histology with reconstruction of a random facial flap. Due to the difficulty defining the borders of the tumor it was decided not to use the per-operative freezing histology. Instead it was decided to leave the defect open until final histology. Reconstruction with a random flap were discussed for the 2-step-procedure. It was assessed that a bilateral nasolabial flap could cover the defect on the apex of the nose or alternatively a nasofrontal flap. The patient was included in the decision and did not wish for reconstruction with the nasofrontal flap as she was not happy with her forehead.
1
The tumor was marked and a surgical margin of 5 mm was drawn.
2
The tumor was excised in 5 mm margin including subdermal slim tissues and marked a 12 o clock for the histologic assessment. The defect was left open and histology showed that the tumor was radically excised.
3
Drawing for the bilateral nasolabial flaps.
4
The patient was not happy with the cosmetic result of her nose. The flaps are very thick leaving her nose with a wide expression. The profile of the nose was quite good. The patient is now in pre-operative planning for surgical thinning of the flap.
