Doppler-guided supratrochlear artery-based forehead paramedian flap for nasal defect reconstruction in patients with basal cell carcinoma
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Objectives: The present study was designed to assess the outcome of supratrochlear arterybased 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. Patients were assigned for lesion excision and defect closure by supratrochlear artery-based paramedian forehead flap. Aesthetic outcome was judged and scored as excellent (score=4), good (score=3), fair (score=2) and poor (score=1). 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 offorehead 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(76.5%) patients; no changes in 3 (1 7.6%) patients and one patient (5.8%) reported worsening of breathing. Conclusion: Paramedian forehead flap could be considered an appropriate procedure for nasal construction after excision of BCC as it offers similar colour, texture, with high satisfaction rate of aesthetic and functional outcome.