Supratrochlear artery-based Forehead Paramedian Flap is appropriate Surgical Modality for Nasal Defects Reconstruction in Patients with Basal Cell Carcinoma
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Objectives: The present study was designed to assess the outcome of supratrochlear artery-based paramedian forehead flap for nasal reconstruction after basal cell carcinoma (BCC) surgical treatment Patients & Methods: The study included 17 patients; 13 males and 4 females with mean age of 53.2±6.3 years with biopsy confirmed BCC. After clinical evaluation, patients were assigned for lesion excision and defect closure by forehead flap using Menick's technique. After a minimal follow-up time of a least 3 months; aesthetic outcome was judged and scored as excellent (score=4), good (score=3), fair (score=2) and poor (score=1). The same criteria were also applied to the donor site scar. The functional result was judged regarding evaluation of their breathing through the reconstructed side compared with preoperative function and expressed as better, the same, slightly worse, or much worse than preoperatively. Results: The mean aesthetic outcome of forehead flap was 3.2±0.9; 9 patients (52.9%) found the aesthetic appearance of the recipient area excellent, another 5 patients (29.5%) found it good, 2 patients (11.8%) found the outcome fair and only one patient (5.8%) reported poor outcome. As regards the donor area; 2 patients (11.8%) found the donor area aesthetically poor, another patient (5.8%) found it fair, 2 patients (11.8%) found it good while the remaining 12 patients (70.6%) found it excellent. Functional outcome expressed as breathing self-assessment in comparison to preoperative assessment was better in 13 patients; no changes in 3 patients and one patient reported worsening of breathing. No postoperative morbidity was reported apart from occurrence of mild infection of the exposed part of forehead flap that was mildly edematous immediately postoperative but infection and edema subsided on conservative treatment. Three patients developed minor hematoma that resolved on cold foments and conservative treatment. Conclusion: Paramedian forehead flap could be considered an appropriate procedure for nasal construction after excision of BCC and provided excellent color match with nasal skin and 82.4% satisfaction rate of aesthetic outcome of recipient area and 76.5% functional improvement rate without notable postoperative complications.