Osteocutaneous Femur Perforator Flap for Salvage Reconstruction of the Nasal Septum and Columella

• DOI: 10.1097/prs.0b013e318287a0f6
• Publication Date: 2013-04-30T12:34:19Z
• Authors: Farzad Borumandi; Heinz Bürger; Christian Brandtner; Alexander Gaggl
• Keywords: Columella

Sir: The characteristic shared by suitable free flaps for nasal reconstruction is their small size and thin cutaneous tissue, which allows creation of the contour around framework inner lining without airway obstruction.1 We introduce medial condyle femur as a new donor site complex defects. Furthermore, feasibility osteocutaneous perforator flap septum columella demonstrated. osseous its use microvascular bony defects already well described in literature.2–5 To best our knowledge, has not been previously. After ablation carcinoma, we reconstructed subtotal defect primarily combination an paramedian forehead (Figs. 1 2). served regional skin to cover pyramid after flap. recipient was prepared dissection right supratrochlear artery vein anastomosis. bone raised from distal same fashion By combining with flap, nose satisfactorily tissue having similar texture color surrounding facial (Fig. primary adjuvant localized irradiation (60 Gy), necrotized, requiring secondary reconstruction. decided synchronous columella. at superior labial were dissected anastomosis intraoral approach. A Doppler ultrasound device used identify vessels lying over femur. required island incised identified fascia vastus muscle. proximally. Further steps raising osteoperiosteal part performed known fashion.3 harvested placed vertically reconstruct anterior deficient part. descending genicular connected intraorally vein. hinged femoral reconstructing In third operation, reduced formed improve appearance 2).Fig. 1: operation situs ablation.Fig. 2: patient final contouring reduction replacing columella.In conclusion, can be cut bent, remains attached vascularized periosteal layer lining. pedicle sufficient length vessels. offers alternative patients thick subcutaneous fat layer, defatted or it may beneficial regions that have will irradiated. PATIENT CONSENT provided written consent patient’s images. DISCLOSURE authors no financial interest declare relation content this article. No external funding received. Farzad Borumandi, M.D., D.M.D. Department Oral Maxillofacial Surgery Paracelsus Medical University Salzburg, Austria Heinz Bürger, M.D. Traumatology Hand Hospital Klagenfurt Klagenfurt, Christian Brandtner, Alexander Gaggl, D.M.D., Ph.D.