The Vascular Anatomical Basis for a Well-Designed Reconstruction of the Ala Nasi by a Microsurgical Preauricular Flap Technique
<b>Background:</b> A microsurgical auricular flap represents a single-step technique for the reconstruction of full-thickness defects of the ala nasi. To achieve the best surgical outcomes, it is essential to have an exhaustive knowledge of the vascular network to improve the management...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-11-01
|
| Series: | Surgical Techniques Development |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2038-9582/13/4/29 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846102651181203456 |
|---|---|
| author | Gianpaolo Faini Alice Ferrari Lena Hirtler Lorena Giugno Sergio Arleo Barbara Buffoli |
| author_facet | Gianpaolo Faini Alice Ferrari Lena Hirtler Lorena Giugno Sergio Arleo Barbara Buffoli |
| author_sort | Gianpaolo Faini |
| collection | DOAJ |
| description | <b>Background:</b> A microsurgical auricular flap represents a single-step technique for the reconstruction of full-thickness defects of the ala nasi. To achieve the best surgical outcomes, it is essential to have an exhaustive knowledge of the vascular network to improve the management of the surgical flap. This study aimed to provide an anatomical and surgical guide for a well-designed reconstruction of the ala nasi using a free preauricular flap. <b>Methods</b>: In this study, three fresh-frozen and two formalin-fixed human head specimens injected with red silicone rubber to enhance the arterial facial system were used. The reconstruction of the full-thickness defect of the ala nasi was performed using a microsurgical auricular flap technique, with the dimensions of the ala nasi and the preauricular flap duly noted. In addition, anatomical dissections were conducted, during which the positions and diameters of the main donor and recipient vessels were measured. <b>Results</b>: A presurgical evaluation was performed to define the flap design. A comparison of the shape and mean dimensions of the ala nasi defect (height 9.66 ± 1.40 mm; thickness 3.52 ± 0.53 mm) and the preauricular flap (height 8.50 ± 2.68 mm; thickness 3.92 ± 1.29 mm) indicated that this flap was an optimal option for the reconstruction of the ala nasi. The surgical procedure involved the full-thickness removal of the ala nasi, and the harvesting and insertion of the preauricular flap. The anatomical measurements demonstrated that the facial artery and veins were the optimal recipient vessels, with a diameter of >1 mm (2.08 ± 0.56 and 2.85 ± 0.74 mm), suitable for anastomosis with the superficial temporal artery and vein (1.86 ± 0.58 and 1.66 ± 0.15 mm). In addition, the postsurgical evaluations indicated a slight mean difference in the thickness (1.14 ± 0.65 mm) and height (1.68 ± 1.18 mm) between the ala nasi and helix and a satisfactory VAS score (7.9 ± 0.57). <b>Conclusions</b>: Our surgical and anatomical data provide compelling evidence in favour of free preauricular flap reconstructions of the ala nasi. This procedure allows for the correct choice of recipient vessels and the creation of a well-designed surgical flap. |
| format | Article |
| id | doaj-art-88e1f100ecca4870b54c1b60792cc01c |
| institution | Kabale University |
| issn | 2038-9582 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgical Techniques Development |
| spelling | doaj-art-88e1f100ecca4870b54c1b60792cc01c2024-12-27T14:54:47ZengMDPI AGSurgical Techniques Development2038-95822024-11-0113437138110.3390/std13040029The Vascular Anatomical Basis for a Well-Designed Reconstruction of the Ala Nasi by a Microsurgical Preauricular Flap TechniqueGianpaolo Faini0Alice Ferrari1Lena Hirtler2Lorena Giugno3Sergio Arleo4Barbara Buffoli5Department of Surgery, Operative Unit of Reconstructive Surgery and Microsurgery, ASST Valle Camonica, 25040 Brescia, ItalyDivision of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, ItalyDivision of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, 1090 Vienna, AustriaDivision of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, ItalyDepartment of Surgery, Operative Unit of Reconstructive Surgery and Microsurgery, ASST Valle Camonica, 25040 Brescia, ItalyDivision of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy<b>Background:</b> A microsurgical auricular flap represents a single-step technique for the reconstruction of full-thickness defects of the ala nasi. To achieve the best surgical outcomes, it is essential to have an exhaustive knowledge of the vascular network to improve the management of the surgical flap. This study aimed to provide an anatomical and surgical guide for a well-designed reconstruction of the ala nasi using a free preauricular flap. <b>Methods</b>: In this study, three fresh-frozen and two formalin-fixed human head specimens injected with red silicone rubber to enhance the arterial facial system were used. The reconstruction of the full-thickness defect of the ala nasi was performed using a microsurgical auricular flap technique, with the dimensions of the ala nasi and the preauricular flap duly noted. In addition, anatomical dissections were conducted, during which the positions and diameters of the main donor and recipient vessels were measured. <b>Results</b>: A presurgical evaluation was performed to define the flap design. A comparison of the shape and mean dimensions of the ala nasi defect (height 9.66 ± 1.40 mm; thickness 3.52 ± 0.53 mm) and the preauricular flap (height 8.50 ± 2.68 mm; thickness 3.92 ± 1.29 mm) indicated that this flap was an optimal option for the reconstruction of the ala nasi. The surgical procedure involved the full-thickness removal of the ala nasi, and the harvesting and insertion of the preauricular flap. The anatomical measurements demonstrated that the facial artery and veins were the optimal recipient vessels, with a diameter of >1 mm (2.08 ± 0.56 and 2.85 ± 0.74 mm), suitable for anastomosis with the superficial temporal artery and vein (1.86 ± 0.58 and 1.66 ± 0.15 mm). In addition, the postsurgical evaluations indicated a slight mean difference in the thickness (1.14 ± 0.65 mm) and height (1.68 ± 1.18 mm) between the ala nasi and helix and a satisfactory VAS score (7.9 ± 0.57). <b>Conclusions</b>: Our surgical and anatomical data provide compelling evidence in favour of free preauricular flap reconstructions of the ala nasi. This procedure allows for the correct choice of recipient vessels and the creation of a well-designed surgical flap.https://www.mdpi.com/2038-9582/13/4/29full-thickness nasal defectala nasimicrosurgical auricular flaphuman head specimens |
| spellingShingle | Gianpaolo Faini Alice Ferrari Lena Hirtler Lorena Giugno Sergio Arleo Barbara Buffoli The Vascular Anatomical Basis for a Well-Designed Reconstruction of the Ala Nasi by a Microsurgical Preauricular Flap Technique Surgical Techniques Development full-thickness nasal defect ala nasi microsurgical auricular flap human head specimens |
| title | The Vascular Anatomical Basis for a Well-Designed Reconstruction of the Ala Nasi by a Microsurgical Preauricular Flap Technique |
| title_full | The Vascular Anatomical Basis for a Well-Designed Reconstruction of the Ala Nasi by a Microsurgical Preauricular Flap Technique |
| title_fullStr | The Vascular Anatomical Basis for a Well-Designed Reconstruction of the Ala Nasi by a Microsurgical Preauricular Flap Technique |
| title_full_unstemmed | The Vascular Anatomical Basis for a Well-Designed Reconstruction of the Ala Nasi by a Microsurgical Preauricular Flap Technique |
| title_short | The Vascular Anatomical Basis for a Well-Designed Reconstruction of the Ala Nasi by a Microsurgical Preauricular Flap Technique |
| title_sort | vascular anatomical basis for a well designed reconstruction of the ala nasi by a microsurgical preauricular flap technique |
| topic | full-thickness nasal defect ala nasi microsurgical auricular flap human head specimens |
| url | https://www.mdpi.com/2038-9582/13/4/29 |
| work_keys_str_mv | AT gianpaolofaini thevascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT aliceferrari thevascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT lenahirtler thevascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT lorenagiugno thevascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT sergioarleo thevascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT barbarabuffoli thevascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT gianpaolofaini vascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT aliceferrari vascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT lenahirtler vascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT lorenagiugno vascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT sergioarleo vascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique AT barbarabuffoli vascularanatomicalbasisforawelldesignedreconstructionofthealanasibyamicrosurgicalpreauricularflaptechnique |