Single-Pedicled Myocutaneous Flap of the Nose: A Case Study with Scar Quality Assessment

Abstract

The plastic reconstruction of the nose after microscopically controlled tumor surgery poses a particular challenge. The single pedicled nasalis myocutaneous flap is suited for the repair of defects of the distal nose. The flap is characterized by great tissue mobility and ensured vascular supply. Below a case study is presented that involves 4 patients who were treated with this special flap in our hospital after excision of a basal cell carcinoma. The scar quality was measured after one year with the scar assessment tool POSAS (The Patient and Observer Scar Assessment Scale). The single pedicled nasalis myocutaneous flap healed without any complication in all 4 patients. The nose shape could be preserved by the almost tension-free shift of the flap on the myocutaneous pedicle. The evaluation with the POSAS showed good results for all individual parameters and in the overall assessment. The single pedicled nasalis myocutaneous flap offers a good alternative to repair defects on the distal nasal bridge, nasal ala and the nasal tip. The pedicle provides a maximum on mobility combined with a good perfusion of the flap. As the flap is built out of nose tissue the color and texture can be kept which leads to an excellent cosmetic result. The good results are also reflected by the evaluation of the POSAS data.