Abstract
Alar reconstruction can pose a challenging task in reconstructive surgery. Herein,
we describe a case of a large full-thickness alar defect (involving the full- thickness
of the left ala, 50% of the tip of the nose and extending over the left nasal sidewall
and cheek) that was reconstructed using a contralateral free composite pinna flap,
which extended into the right temple. A 70-year-old man with a squamous cell carcinoma
to the left ala underwent surgical excision and immediate reconstruction with an extended
contralateral free composite pinna flap based on a branch of the right superficial
temporal artery supplying the helical root and the skin paddle of the supra-auricular
area. The patient had an uneventful recovery and the result was aesthetically pleasing
without compromising the nostril or the external nasal valve. Based on this case,
a free composite flap incorporating the contralateral root of helix and adjacent tissue
from the temporal region is an option that could be used in a single-staged procedure
for reconstruction of large full-thickness alar defects. One of the challenges of
performing free flaps in this area is the paucity of suitable recipient veins. This
can be reliably addressed with a vein graft.
Keywords
nasal ala - alar reconstruction - nasal reconstruction
