Prelaminated fascia lata free flap for large nasal septal defect reconstruction

J Plast Reconstr Aesthet Surg. 2014 Oct;67(10):1440-3. doi: 10.1016/j.bjps.2014.05.027. Epub 2014 Jun 2.

Abstract

Nasal septal defects can be challenging to repair, given their location, size, and the unique, tri-layered structure of the septum, which includes a thin piece of cartilage positioned between mucosal layers. The report herein presents a case of a 47 year-old woman with a large symptomatic nasal septal perforation, despite saline irrigations and ointment. Placement of a septal button or a traditional surgical approach was not considered because of the extremely large nature of the perforation. We describe the use of a tri-layered fascia lata flap prelaminated with buccal mucosa grafts to successfully repair this complicated defect. Subsequent follow-up visits showed complete repair of the defect and patent nasal passages, without the need for any debulking procedures. Based on these results, we conclude that a prelaminated fascia lata flap is a good reconstructive option for large, complex nasal septal defects, bringing thin, healthy mucosalized tissue to the defect and minimizing future surgical procedures.

Keywords: Fascia lata; Free flap; Nasal septal defect; Prelamination.

Publication types

  • Case Reports

MeSH terms

  • Cartilage / transplantation
  • Fascia Lata / transplantation
  • Female
  • Humans
  • Middle Aged
  • Mouth Mucosa / transplantation
  • Nasal Septal Perforation / surgery*
  • Nasal Septum / pathology
  • Nasal Septum / surgery*
  • Reconstructive Surgical Procedures / methods*
  • Surgical Flaps*