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Resection and Reconstruction of Head & Neck Cancers pp 119–137Cite as

Nasal Reconstruction

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Part of the book series: Head and Neck Cancer Clinics ((HNCC))

Abstract

The nose is a psychologically significant structure over the central face with intricate functional and aesthetic qualities that can be considerably challenging to reconstruct. Unique contours and shadows of the nasal dorsum are found nowhere else on the body; full-thickness defects must be rebuilt from scratch.

Nasal reconstruction has passed through the stages of cover, lining, and support. Achieving consummation of each stage is based on precise diagnosis and sophisticated surgical design. Visual and artistic ideas are always keys to influence optimal results.

Forehead flaps are acknowledged as the best tool to resurface nasal defects. Also, folded microvascular ulnar forearm flaps have provided reliable and strong nasal foundations. Combination of the above methods can restore the missing tissue for the composite defects in total or subtotal nasal reconstruction.

Nasal cartilage framework has to be stable and solid in order to hold the surfacing flap and protect the nose from postoperative nasal collapse of the dorsum or the vaults. The chimeric autologous costal cartilage onlay graft has been developed to prevent warping.

In terms of enhancement of aesthetic outcome at donor site in forehead flap reconstruction, preoperative botulinum toxin injection is proposed.

Based on Chang Gung Memorial Hospital experiences, some innovative refinements are proposed in order to achieve optimal, functional, and aesthetic results in nasal reconstruction.

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Author information

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Yen-Chang Hsiao & Cheng-I Yen

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  1. Yen-Chang Hsiao
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  2. Cheng-I Yen
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Editor information

Editors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Ming-Huei Cheng

  2. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Kai-Ping Chang

  3. Department of Otolaryngology – Head & Neck Surgery, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Huang-Kai Kao

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Hsiao, YC., Yen, CI. (2019). Nasal Reconstruction. In: Cheng, MH., Chang, KP., Kao, HK. (eds) Resection and Reconstruction of Head & Neck Cancers. Head and Neck Cancer Clinics. Springer, Singapore. https://doi.org/10.1007/978-981-13-2444-4_9

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  • DOI: https://doi.org/10.1007/978-981-13-2444-4_9

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-2443-7

  • Online ISBN: 978-981-13-2444-4

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