Abstract
Background
Nose reconstruction is challenging given the three-dimensional structure and free edge, and various methods have been reported. In general, local flaps provide cosmetic outcomes that are better than those following skin grafts, but there are no published comparative studies on Asians.
Objectives
To determine whether local flaps or skin grafts may optimally be used to reconstruct external nasal defects among Asians.
Materials & Methods
We retrospectively collected data on patients who underwent external nasal tumour resection and reconstruction by 14 plastic surgeons in eight Japanese institutes from 2009 to 2021. The cosmetic results were scored by 14 surgeons using anonymized preoperative and six-month postoperative photographs. Scores for each reconstruction method were statistically evaluated.
Results
In total, 86 cases were enrolled; 57 received local flaps and 29 received skin grafts. Most local flaps showed better outcomes compared to skin grafts, but this was not the case for nasolabial and forehead flaps. Notably, local flaps placed in the nasal ala tended to be less successful than flaps placed elsewhere; only the bilobed flap scored better than skin grafts. The defect site did not affect the results of skin grafts.
Conclusion
For Asians requiring nasal reconstruction, local flaps provide better cosmetic outcomes than skin grafts, except for those in the nasal ala. Skin grafts may be a good alternative when the bilobed flap is unavailable for the nasal ala.
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Acknowledgments
we thank Dr. Kiyoshi Yamada of Kousei Hospital and Dr. Aya Ohno of Okayama University for their help with protocol preparation, and Dr. Toshiharu Mitsuhashi of Okayama University for assistance with the statistical analysis.
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Research ethics: this study was approved by the Institutional Review Board of Ehime University Hospital (approval number 1907008).
Conflicts of interest: none.
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Tozawa, A., Mori, H., Ao, M. et al. Reconstruction methods for and cosmetic evaluation of external nasal tumour resections: flap versus graft. Eur J Dermatol 33, 524–529 (2023). https://doi.org/10.1684/ejd.2023.4561
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DOI: https://doi.org/10.1684/ejd.2023.4561