Objective: We present a previously unreported technique which we have found useful for closure of the donor site created by a paramedian forehead flap, during nasal reconstruction.
Case report: An 80-year-old woman was referred to the ENT department for management of a large tumour involving the left nasal dorsum. The lesion measured 2.5 x 2.5 cm, and an incisional biopsy confirmed moderately differentiated squamous cell carcinoma. Complete excision with an interpolated paramedian forehead flap reconstruction was performed. The pedicle was divided three weeks post-operatively, and the 2 x 2 cm forehead defect was closed at this time. A frontalis muscle flap and full thickness skin graft were used to close the donor site.
Conclusion: A frontalis muscle flap is a novel method of closing large forehead defects created by a paramedian forehead flap. A frontalis muscle flap provides a healthy base for a full thickness skin graft, which allows good skin colour matching and an enhanced cosmetic result.