A paramedian forehead flap based on the axial artery and vein for nasal defects

Abstract

Aim: The paramedian forehead flap is the first choice for reconstructing nasal defects when local tissue is insufficient. Arterial supply to the flap is based on the supratrochlear and supraorbital arteries. Venous drainage from the flap has been a neglected area in the planning of a forehead flap. In this study, a paramedian forehead flap was planned to include the supratrochlear artery and vein for nasal defects. Material and Methods: This retrospective study included 17 patients (11 males and 6 females) with a mean age of 59.47 years (range, 45–88 years) who were treated with a forehead flap for a nasal defect between January 2011 and January 2017. All operations were performed under general anesthesia; mean operation time was 95 min. Results: The forehead flap was transferred in two stages in 11 patients and one stage in 6 patients. Bleeding from the flap edge and congestion were less frequent in our forehead flaps than a conventional forehead flap. No flap was lost in any patient. Conclusion: Venous insufficiency may result in loss of the forehead flap; therefore, including the vein may reduce potential flap loss