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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(02): 184-194
DOI: 10.1055/s-0042-1744426
Pediatric/Craniomilofacial/Head & Neck
Review Article

Outcomes Associated with Nasal Reconstruction Post-Rhinectomy: A Narrative Review

Jithin John
1   School of Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan
,
Rohun Gupta
1   School of Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan
,
Anne Grossbauer
1   School of Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan
,
Michael Chung
2   Department of Otolaryngology, Wayne State University, Detroit, Michigan
,
Anita Sethna
3   Department of Otolaryngology, Emory University, Atlanta, Georgia
,
Michel Abboud
2   Department of Otolaryngology, Wayne State University, Detroit, Michigan
,
Eric Cox
4   Department of Otolaryngology, Beaumont Health Systems, Royal Oak, Michigan
,
Justin Hart
5   Department of Plastic Surgery, Beaumont Health Systems, Royal Oak, Michigan
,
Adam Folbe
4   Department of Otolaryngology, Beaumont Health Systems, Royal Oak, Michigan
,
Kongkrit Chaiyasate
5   Department of Plastic Surgery, Beaumont Health Systems, Royal Oak, Michigan
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Abstract

The face and the external nose define an individual's physical appearance. Nasal deformities can cause facial disfigurement along with unwanted psychological repercussions. Nasal deformities range in severity, with the most severe cases being indications for a rhinectomy, due to the complexity of the nasal defect. According to published literature, there is no consensus among otolaryngologists and plastic surgeons on which technique or flap use is preferred in terms of complications, aesthetic outcome, or patient satisfaction. The goal of this study is to provide a comprehensive analysis of published studies on nasal reconstruction following rhinectomy. Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines for writing systematic reviews, a systematic review was conducted. Four databases were searched using a search strategy. These articles were then imported into the COVIDENCE software and went screening and thorough article review. After screening 2,237 articles, 23 studies were then extracted for data collection analysis. We collected data from 12 case series, 4 case studies, 1 prospective case series, and 4 retrospective chart review studies. The most commonly reported flaps were forehead flaps, superior extended nasal myocutaneous island, forearm free flaps, anterolateral thigh (ALT) free flap, medial femoral condyle free flap (n = 8), and zygomaticus implants (n = 6), and retained nasal prosthesis. Although not specifically indicated by a certain number, the most common indication for the rhinectomy was malignancy, followed by traumas, postsurgical complications, radionecrosis, and congenital nasal malformations.

Although several donor flaps can be used after rhinectomy, we conclude that there is no preference over what flap has superior patient outcomes after analysis. As of current, there are no prospective studies that exist. Therefore, more research is necessary to determine the results of each flap.

Keywords

rhinectomy - nasal reconstruction - flaps - total reconstruction

Search Terms

(“nasal reconstruction” OR “rhinectomy” OR “Nasal reconstructive surger*” OR “total nasal recon*” OR “total nose recon*” OR “septal reconstruction” OR “epithetic nasal recon*” OR “nose removal” OR “nose neoplasm” OR “rhinoplasty” OR “nose surgery”) AND (“local flap” OR “forehead flap” OR “cartilage graft” OR “free flap” OR “ALT flap” OR “forearm flap” OR “forearm free flap” OR “surgical flap” OR “anterolateral thigh flap” OR “osteocutaneous radial forearm free flap” OR “nasal prost*”)


Author Contributions

J.J.: Conceptualization, formal analysis, investigation, methodology, supervision, visualization, writing–original draft, writing–review and editing. R.G.: Corresponding author, formal analysis, investigation, methodology, supervision, writing–review and editing. A.G.: project administration, supervision, visualization, writing–original draft, Writing–review and editing. M.C.: Conceptualization, formal analysis, investigation, methodology, validation, visualization. A.S.: Supervision, validation, writing–review and editing. M.A.: Supervision, validation, writing–review and editing, resources. E.C.: Conceptualization, data curation, investigation, project administration, resources, supervision. J.H.: Supervision, validation, writing–review and editing. A.F.: Supervision, validation, writing–review and editing. K.C.: Supervision, validation, writing–review and editing.




Publication History

Article published online:
06 April 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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