Single Stage Reconstruction of Composite Rhinectomy Defects Using Osteocutaneous Radial Forearm Free Flap

Head Neck. 2024 Dec 20. doi: 10.1002/hed.28042. Online ahead of print.

Abstract

Background: Composite rhinectomy defects pose significant challenges due to the nose's complex structure and role in facial esthetics and function. Traditional nasal reconstructions often require multiple stages to restore mucosal lining, structural support, and external skin.

Methods: This case series examines the use of a single-stage osteocutaneous radial forearm free flap (OCRFFF) for composite rhinectomy reconstruction. Three patients who underwent composite rhinectomy due to malignancy were treated using OCRFFF, which allows for simultaneous reconstruction of composite nasal defects by incorporating skin, bone, and fascial tissue.

Results: All three cases achieved successful postoperative outcomes, demonstrating both cosmetic and functional success without significant long-term complications. The single-stage approach streamlined the reconstructive process, reducing patient recovery time and the need for additional surgeries.

Conclusions: OCRFFF is an effective, transformative technique for single-stage nasal reconstruction for composite rhinectomy defects, providing reliable functional and esthetic outcomes, and contributing to advancements in complex nasal defect management.

Keywords: free tissue transfer; osteocutaneous radial forearm free flap; reconstruction; single stage; total rhinectomy.