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Case Report



Reconstruction of nasal sidewall defect using transposition advancement flap: one year follow up

Khairuddin Djawad.




Abstract
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The nasal area has a three-dimensional structure that forms the centrepiece for the face. Defects in this area are among the most challenging for surgical reconstruction. The aim of nasal reconstruction is to restore both the form and function of the nose. The reconstructive modality of choice will depend on the location, size, and depth of the surgical defect. Here we report the case of an 80-year-old female with basal cell carcinoma (BCC) of the nasal sidewall. The diagnosis was made based on clinical features, dermoscopic, and histopathologic examination. The patient was treated with Modified Mohs Micrographic Surgery (MMS), and tumour-free margins were achieved after the second stage. Nasal skin defect reconstruction was carried out with a combination of transposition and advancement flap. Modified rhombic transposition flap took advantage of glabellar laxity to repair the nasal sidewall wound. Advancement flap of the cheek maintains the borders of cosmetic units and allows closure lines to be placed discretely along the lower eyelid cheek junction and nasolabial fold. No evidence of recurrence or alteration of nasal function was reported at one-year follow-up. Therefore, we conclude that transposition advancement flap is a useful alternative method for large nasal skin defect reconstruction.

Key words: transposition advancement flap, surgery, nasal sidewall






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