RECONSTRUCTION OF NASAL ALAR DEFECT;

USE OF NASOLABIAL SKIN FLAP

Abstract

Objective: To assess the outcome of nasolabial flap for ala plasty in patients with alar defect. Design: Descriptive study.
Setting: Department of E.N.T, Head & Neck Surgery Postgraduate Medical Institute (PGMI) Lady Reading Hospital (LRH) Peshawar. Period:
January 2006 to December 2007. Material & Methods: In this study we included 35 patients. A detailed history and thorough physical
examination regarding general condition of the patient and specifically E.N.T of the patient with emphasis on the alar soft tissue deformity, both
from cosmetic and functional aspect was recorded on preformed proforma. Pre-operative and post-operative photographs were taken after
taking written consent from all the patients. All procedures were carried out under local infiltrative anesthesia and were covered by intravenous
prophylactic antibiotics. These patients were followed at one month, six month and one year intervals. Result: Our study included 35 patients of
nasal ala plasty with superiorly based nasolabial flap. Out of 35 patients 26 (74.29%) were males and 9 (25.71%) were female with female to
male ratio of 1:2.8. Males dominated nasal deformity as males are more exposed to trauma. Average age in males was 47 years (range 24-70
years) and in females it was 48.5 years (range 27-70 years). The patients presented with nasal alar deformity in the age range from 25 to 70
years, while 19 patients (54.28%) presented during 31 to 50 years of age. Trauma was dominated (n=28, 80%) among the causative factors for
alar soft tissue loss in these 35 patients. Twenty-eight (80.00%) patients were fully satisfied both cosmetically and functionally, 04 patients
(11.42%) were partially satisfied only cosmetically and 03 patients (8.57%) were not satisfied with their nasal cosmetic improvement and
functional results. Conclusions: Nasal ala plasty with superiorly based nasolabial flap provide good cosmetic result with minimal
complications.