Arnas Martinėlis1, Lina Kuliešytė1, Rūta Venciūtė2, prof. Kęstutis Vitkus2
1 Lithuanian University of Health Sciences, Medicine faculty, Kaunas, Lithuania.
2 Vilnius University Hospital Santaros Klinikos, Plastic and reconctructive surgery center, Vilnius, Lithuania.
Basal cell carcinomas (BCC) and its destructive treatment methods can cause wide spread destruction of nose and reconstruction can be challenging. The paramedian forehead flap (PMFF) is a versatile pedicled flap with a robust vascular supply, based upon supratrochlear artery, that is well suited for reconstruction of complex or large nasal defects. The forehead skin is recognized as the best donor site for resurfacing the nasal defects. In this case report, we present a female 68 years-old patient, who 6 years ago was diagnosed with a BCC involving right side and dorsal part of the nose. After CO2 laser ablations and aminolevulinic acid–based photodynamic therapy patient was left with a visible around 2,1 cm size defect on the right ala. Furthermore, she was complaining about breathing difficulties. To achieve a functional nose without breathing disturbances and good aesthetic outcomes was the main goal for dermatologists and plastic surgeons. So it was decided to perform PMFF procedure in 2 stages. Our patient tolerated the surgical procedures well with no surgical or anesthesia-related complications. In conclusion, reconstruction of defects created by removal of cancer is very important in successful skin cancer treatment and patient satisfaction. The forehead flap represents one of the best methods for repair of extensive nasal defects.
Keywords: reconstruction, basal cell carcinoma, nasal defect, paramedian forehead flap