A compendium of intranasal flaps

Abstract

The reconstructive surgeon is frequently called upon to repair intranasal defects which require the use of grafts and/or flaps. In general, flaps are difficult to design and utilize because of 1. limited intranasal exposure and 2. the complex design requirements for movement of the flap through three dimensions. Intranasal exposure is increased by the transoral premaxillary approach, the lateral alotomy, the lateral rhinotomy, the transethmoid, and the open rhinoplasty. The flaps to be designed all utilize the basic principles for skin flaps. However in contrast to movement on a relatively two-dimensional surface, they frequently require movement in the three dimensions, i.e., from the floor of the nose up to the septum, from the side to the center, etc. We review the following flaps: 1. mucoperichondrial advancement and rotation flaps of the septum, 2. composite septal flap, 3. inferior turbinate flaps, 4. nasal floor mucoperiosteal flaps, 5. middle turbinate flaps, 6. composite lateral cartilage flaps, 7. buccal sulcus flaps, and 8. nasolabial flaps.