In a retrospective analysis, researchers found the central artery forehead flap was as reliable in terms of vascularity as the glabellar and classis paramedian forehead flap for nasal reconstruction.
The study population consisted of 300 patients who underwent primary forehead flap reconstruction of nasal defects during a 19-year period, where surgeons used either the classic paramedian forehead flap, a glabellar paramedian forehead flap or a central artery forehead flap. All patients had more than 3 months’ postoperative follow-up data and photographic documentation.
The study’s main outcomes and measures included patient characteristics, method of repair, complications, functional outcomes and patient satisfaction scores. Mean follow-up duration was 24 months.
The researchers found no instances of vascular compromise during the first stage of nasal reconstruction. In one intermediate-stage and three final-stage procedures, partial flap necrosis was reported; however, there were no significant differences in the rate of vascular compromise between the three flap cohorts, according to the researchers. Overall, the rates of necrosis were significantly higher among diabetic patients.
Central artery flap cases were found to have lower hair transposition to the nose compared with the classic paramedian and glabellar flap designs (7% vs. 23% and 13%, respectively).
The researchers evaluated the cosmetic outcome in 227 of the patients (76%) with 3 months of follow-up. Pairwise comparisons between the groups demonstrated no significant differences with regard to brow position or color match between the groups, according to the researchers. – by Abigail Sutton
Disclosure: The authors have no relevant financial disclosures.