Facial plast Surg 2019; 35(03): 286-293
DOI: 10.1055/s-0039-1688703
Original Research
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pediatric Nasal Reconstruction by Washio Procedure

Sara Caterina Maria O'Rourke
1  Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
,
Cecilia Neiva
1  Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
,
Eva Galliani
1  Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
,
Natacha Kadlub
1  Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
2  Department of Maxillofacial and Plastic Surgery, Université Paris Descartes-Sorbonne Paris Cité, Paris, France
,
Arnaud Picard
1  Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
2  Department of Maxillofacial and Plastic Surgery, Université Paris Descartes-Sorbonne Paris Cité, Paris, France
,
Anne Morice
1  Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
2  Department of Maxillofacial and Plastic Surgery, Université Paris Descartes-Sorbonne Paris Cité, Paris, France
› Author Affiliations
Funding None.
Further Information

Publication History

Publication Date:
17 May 2019 (online)

Abstract

The use of the Washio retroauricular flap for nasal reconstruction has been infrequently covered in recent literature, particularly concerning the pediatric population. A retrospective study was conducted between 2014 and 2018 and included all pediatric patients who underwent a Washio retroauricular flap procedure for nasal reconstruction operated on by the same surgeon at a referral center for pediatric plastic and maxillofacial surgery. The mean age at the time of the first stage of the Washio procedure was just under 8 years of age (range: 6 years 3 months–8 years 10 months). The Washio retroauricular flap procedure was successfully employed in three patients with three different anatomical defects, including the nasal alae, nasal tip, and columella, without postoperative healing complications. Arguably, the Washio method is sufficiently versatile to be used in various defect types, allows space and planning for subsequent surgical corrections, avoids additional visible scarring of the face, and spares flaps that may be required at the end of the growth, such as the pedicled forehead flap. It is a safe procedure, provided that at least a two-stage procedure is performed, and a progressive postoperative verticalization is prescribed to limit venous drainage complications.

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