Lateral nasal wall mucoperiosteal flap: A versatile new reconstruction of the inner defect of translocated facial bone segments

From July 1998 to December 2002, 42 patients (including 29 patients who had undergone radiation therapy) underwent a newly designed lateral nasal wall mucoperiosteal flap pedicled anteriorly on the lateral nasal artery of the angular artery to resurface a translocated facial bone segment during a facial translocation approach to the skull base to prevent its avascular necrosis. Of the 42 patients studied, 1 patient had full-thickness flap loss that resulted in bone graft necrosis. Another patient had marginal necrosis. The average length, width, and surface area of the flap was 30 mm, 45 mm, and 1350 mm(2) measured on 5 patients. The mucoperiosteal flap tolerated radiation therapy well. The lateral nasal wall mucoperiosteal flap is a simple, reliable flap that provides ample vascularized tissue to resurface the nude translocated facial bone segment during a facial translocation approach to the skull base. It thus prevents its avascular necrosis even after radiation therapy.