Ultralong Pedicled Superficial Temporal Fascia Island Flaps for Lower Nasal Defect

Objective: To explore the method of repairing nose defects of the apex, ala, septum, and even opposite ala nasi with ultralong pedicled superficial temporal fascia (STF) island flaps. Methods: There were 29 cases of defects of the apex nasi, ala nasi, and nasal columella that were reconstructed, of which 12 cases were repaired with frontal-branched STF island flaps, 14 cases with apical-branched STF postauricular island flaps, and 3 cases with prefabricated apical-branched STF postauricular island flaps. The flap areas were arranged from 1.2 x 2.3 to 2.0 x 2.8 cm(2), the length more than 15 cm on average. Liners were reconstructed at the stage of the prefabricating flaps, with free skin graft in the cases of the alae nasi defects. The surfaces of the wound after flap prefabrications were covered by skin graft as well. Result: Twenty-seven cases were successfully taken without blood circulation blocks; the color, texture, and figure were good, and the outcomes were satisfying. Seven nonprefabricated flap cases have epidermis necrosis due to the lack of artery perfusion pressure and venous return handicap, and the epidermis fall off after 1 month; 2 cases of which required secondary surgeries because of partial necrosis. Conclusions: An ultralong pedicled STF island flap is an available way to repair defects of the apex nasi, ala nasi, and nasal columella. The benefits of a prefabricated flap are good blood circulation, primary made liner, and minute injury of the donor site. It is a good method of repairing defects of the apex nasi, ala nasi, nasal septum, and opposite ala nasi simultaneously.