eMedicine Specialties > Dermatology > Surgical

Nasal Reconstruction: Workup

Author: Jonathan Cook, MD, Director of Dermatologic Surgery, Professor, Department of Medicine, Division of Dermatology, Duke University School of Medicine
Contributor Information and Disclosures

Updated: Jan 23, 2009

Workup

Laboratory Studies

  • Because nearly all of these nasal reconstructive procedures are performed in an outpatient setting under local anesthesia, a barrage of preoperative laboratory testing is rarely (if ever) indicated.
  • If the patient's history or examination findings indicate a bleeding tendency, determinations of an intact hemostatic system can be obtained with a platelet count, bleeding time, and prothrombin time/activated partial thromboplastin time. Other laboratory investigations serve little purpose.

More on Nasal Reconstruction

Overview: Nasal Reconstruction
Workup: Nasal Reconstruction
Treatment: Nasal Reconstruction
Multimedia: Nasal Reconstruction
References

References

  1. Cook JL, Perone JB. A prospective evaluation of the incidence of complications associated with Mohs micrographic surgery. Arch Dermatol. Feb 2003;139(2):143-52. [Medline].

  2. Rowe DE, Carroll RJ, Day CL Jr. Mohs surgery is the treatment of choice for recurrent (previously treated) basal cell carcinoma. J Dermatol Surg Oncol. Apr 1989;15(4):424-31. [Medline].

  3. Rohrer TE, Dzubow LM. Conchal bowl skin grafting in nasal tip reconstruction: clinical and histologic evaluation. J Am Acad Dermatol. Sep 1995;33(3):476-81. [Medline].

  4. Cook JL. A review of the bilobed flap's design with particular emphasis on the minimization of alar displacement. Dermatol Surg. Apr 2000;26(4):354-62. [Medline].

  5. Cook JL. Reconstructive utility of the bilobed flap: lessons from flap successes and failures. Dermatol Surg. Aug 2005;31(8 Pt 2):1024-33. [Medline].

  6. Zitelli JA. The bilobed flap for nasal reconstruction. Arch Dermatol. Jul 1989;125(7):957-9. [Medline].

  7. Zitelli JA, Moy RL. Buried vertical mattress suture. J Dermatol Surg Oncol. Jan 1989;15(1):17-9. [Medline].

  8. Fosko SW, Dzubow LM. Nasal reconstruction with the cheek island pedicle flap. J Am Acad Dermatol. Oct 1996;35(4):580-7. [Medline].

  9. Hairston BR, Nguyen TH. Innovations in the island pedicle flap for cutaneous facial reconstruction. Dermatol Surg. Apr 2003;29(4):378-85. [Medline].

  10. Menick FJ. Aesthetic refinements in use of forehead for nasal reconstruction: the paramedian forehead flap. Clin Plast Surg. Oct 1990;17(4):607-22. [Medline].

  11. Menick FJ. A new modified method for nasal lining: the Menick technique for folded lining. J Surg Oncol. Nov 1 2006;94(6):509-14. [Medline].

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  13. Burget GC, Menick FJ. Repair of small surface defects. In: Aesthetic Reconstruction of the Nose. St. Louis, Mo: Mosby-Year Book; 1994:117-56.

  14. Cook J, Zitelli JA. Primary closure for midline defects of the nose: a simple approach for reconstruction. J Am Acad Dermatol. Sep 2000;43(3):508-10. [Medline].

  15. Dzubow LM. Flap dynamics. J Dermatol Surg Oncol. Feb 1991;17(2):116-30. [Medline].

  16. Goldberg LH, Alam M. Horizontal advancement flap for symmetric reconstruction of small to medium-sized cutaneous defects of the lateral nasal supratip. J Am Acad Dermatol. Oct 2003;49(4):685-9. [Medline].

  17. Lambert RW, Dzubow LM. A dorsal nasal advancement flap for off-midline defects. J Am Acad Dermatol. Mar 2004;50(3):380-3. [Medline].

  18. Menick FJ. A 10-year experience in nasal reconstruction with the three-stage forehead flap. Plast Reconstr Surg. May 2002;109(6):1839-55; discussion 1856-61. [Medline].

  19. Menick FJ. Nasal reconstruction: forehead flap. Plast Reconstr Surg. May 2004;113(6):100E-11E. [Medline].

  20. Nguyen TH. Staged cheek-to-nose and auricular interpolation flaps. Dermatol Surg. Aug 2005;31(8 Pt 2):1034-45. [Medline].

  21. Rowe DE, Carroll RJ, Day CL Jr. Long-term recurrence rates in previously untreated (primary) basal cell carcinoma: implications for patient follow-up. J Dermatol Surg Oncol. Mar 1989;15(3):315-28. [Medline].

  22. Silapunt S, Peterson SR, Alam M, Goldberg LH. Clinical appearance of full-thickness skin grafts of the nose. Dermatol Surg. Feb 2005;31(2):177-83. [Medline].

  23. Spear SL, Kroll SS, Romm S. A new twist to the nasolabial flap for reconstruction of lateral alar defects. Plast Reconstr Surg. Jun 1987;79(6):915-20. [Medline].

  24. Zitelli JA. The nasolabial flap as a single-stage procedure. Arch Dermatol. Nov 1990;126(11):1445-8. [Medline].

Further Reading

Keywords

nasal reconstruction, nasal reconstructive procedures, facial reconstruction, surgical flaps, linear repair, split-thickness skin graft, full-thickness skin graft, Burow graft, random pattern cutaneous flap, axial pattern cutaneous flap, rhombic transposition flap, bilobed transposition flap, dorsal nasal rotation flap, nasolabial transposition flap, island pedicle flap, pedicled nasolabial transposition flap, paramedian forehead flap

Contributor Information and Disclosures

Author

Jonathan Cook, MD, Director of Dermatologic Surgery, Professor, Department of Medicine, Division of Dermatology, Duke University School of Medicine
Jonathan Cook, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and American College of Mohs Micrographic Surgery and Cutaneous Oncology
Disclosure: Nothing to disclose.

Medical Editor

Désirée Ratner, MD, Director of Dermatologic Surgery, Professor of Clinical Dermatology, Department of Dermatology, Columbia University Medical Center, New York Presbyterian Hospital
Désirée Ratner, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Medical Association, American Society for Dermatologic Surgery, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: 3M Pharmaceutical Grant/research funds Other; Graceway Pharmaceuticals Grant/research funds Other

Managing Editor

John G Albertini, MD, Consulting Staff, Dermatologic Surgery, The Skin Surgery Center
John G Albertini, MD is a member of the following medical societies: American Academy of Dermatology and American College of Mohs Micrographic Surgery and Cutaneous Oncology
Disclosure: Nothing to disclose.

CME Editor

Glen H Crawford, MD, Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital
Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons
Disclosure: Nothing to disclose.

Chief Editor

William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System
William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology
Disclosure: elsevier Royalty Other; american college of physicians Honoraria Other

 
 
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