Download PDF
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)

Also available at
    Permissions and Reprints

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.

Keywords

nasal reconstruction - Washio retroauricular flap - pediatric patients

Supplementary Material

 

  • References

  • 1 Klingensmith MR, Millman B, Foster WP. Analysis of methods for nasal tip reconstruction. Head Neck 1994; 16 (04) 347-357
    CrossrefPubMedGoogle Scholar
  • 2 Washio H. Retroauricular-temporal flap. Plast Reconstr Surg 1969; 43 (02) 162-166
    CrossrefPubMedGoogle Scholar
  • 3 Henriksson T-G, Nettelblad H. Technical refinements in the Washio tempororetroauricular flap in reconstruction of the nasal wing. Scand J Plast Reconstr Surg Hand Surg 2005; 39 (05) 295-298
    CrossrefPubMedGoogle Scholar
  • 4 Pittet B, Montandon D. Nasal reconstruction in children: a review of 29 patients. J Craniofac Surg 1998; 9 (06) 522-528
    CrossrefPubMedGoogle Scholar
  • 5 Gifford Jr GH, Swanson L, MacCollum DW. Congenital absence of the nose and anterior nasopharynx. Report of two cases. Plast Reconstr Surg 1972; 50 (01) 5-12
    CrossrefPubMedGoogle Scholar
  • 6 van der Meulen JC, Gilbert M, Roddi R. Early excision of nasal hemangiomas: the L-approach. Plast Reconstr Surg 1994; 94 (03) 465-473 , discussion 474–475
    CrossrefPubMedGoogle Scholar
  • 7 Monroy A, Behar P, Nagy M, Poje C, Pizzuto M, Brodsky L. Head and neck dog bites in children. Otolaryngol Head Neck Surg 2009; 140 (03) 354-357
    CrossrefPubMedGoogle Scholar
  • 8 Kuvat SV, Bozkurt M, Kapi E, Karakol P, Yaçsar Z, Güven E. Our treatment approaches in head-neck injuries caused by animal bites. J Craniofac Surg 2011; 22 (04) 1507-1510
    CrossrefPubMedGoogle Scholar
  • 9 Morrison CM, Bond JS, Leonard AG. Nasal reconstruction using the Washio retroauricular temporal flap. Br J Plast Surg 2003; 56 (03) 224-229
    CrossrefPubMedGoogle Scholar
  • 10 Adil E, Goyal N, Fedok FG. Corrective nasal surgery in the younger patient. JAMA Facial Plast Surg 2014; 16 (03) 176-182
    CrossrefPubMedGoogle Scholar
  • 11 Maillard GF, Montandon D. The Washio tempororetroauricular flap: its use in 20 patients. Plast Reconstr Surg 1982; 70 (05) 550-560
    CrossrefPubMedGoogle Scholar
  • 12 Motamed S, Kalantar-Hormozi AJ. Columella reconstruction with the Washio flap. Br J Plast Surg 2003; 56 (08) 829-831
    CrossrefPubMedGoogle Scholar
  • 13 Seguin P, Beziat JL, Freidel M. Amputation of the point of the nose in children due to a dog bite. Repair with a Washio flap. Long-term results [in French]. Rev Stomatol Chir Maxillofac 1986; 87 (03) 153-156
    PubMedGoogle Scholar
  • 14 Maillard GF, Montandon D. Subtotal reconstruction of the nose with a Washio flap [in French]. Ann Chir Plast Esthet 1983; 28 (04) 319-324
    PubMedGoogle Scholar
  • 15 Molloy RG, Crowley B. The arterial anatomy of skin flaps. In: Cormack GC, George B, Lamberty BGH. , eds. British Journal of Surgery 2nd ed. Illustrated: 1994. Edinburgh, United Kingdom: Churchill Livingstone; 1995. ; Vol. 82(9): 1291-1291
    Google Scholar
  • 16 Chen C, Patel R, Chi J. Comprehensive algorithm for nasal ala reconstruction: utility of the auricular composite graft. Surg J (N Y) 2018; 4 (02) e55-e61
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Farkas LG, Posnick JC, Hreczko TM, Pron GE. Growth patterns of the nasolabial region: a morphometric study. Cleft Palate Craniofac J 1992; 29 (04) 318-324
    CrossrefPubMedGoogle Scholar
  • 18 Ferrario VF, Sforza C. Size and shape of soft-tissue facial profile: effects of age, gender, and skeletal class. Cleft Palate Craniofac J 1997; 34 (06) 498-504
    CrossrefPubMedGoogle Scholar