الفهرس 
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Abstract
Background:
The history of nasal reconstruction mirrors the history of plastic surgery, beginning with what commonly is believed to be the earliest plastic surgery procedure recorded. The contemporary plastic surgeon now has an almost bewildering number of reconstructive options from which to select.
Objectives:
The aim of this work is to evaluate the role of various types of flaps in nasal reconstruction.
Methods:
The present study was carried out in the Center for Facial Cosmetic Surgery, University of Michigan Hospital, United States of America. Thirty patients undergoing Nasal Reconstruction with flaps (in the period between September 2005 and August 2006) were evaluated and followed up for a period of six months after surgery. This study, also, included the review of records and analysis of the surgical techniques and their results of the patients who undergone Nasal Reconstruction with flaps within the past 5 years before September 2005.
Results:
During the 6 months follow up period, all complications were documented and reported. In 246 (86%) patients we found a post operative wound edge scar of the primary operative site ranging from noticeable to severe scar. In 8 (2.7%) patients there was an objectionable scar of the flap donor site. In 33 (11.7%) patients there was a change in the shape of the nostril resulting from alar displacement (notching). In 11 (3.9%) patients, necrosis of either the external or internal lining flaps occurred. In 7 (2.5%) patients, mild to moderate infection occurred of either the external or internal lining repair. In 22 (7.8%) patients, nasal contour deformities were found.
The physician scoring of the results for all of the patients ranged from 5 to 10 with a mean 8.39 ± 0.962. The commonest score was 9 and was found given to 119 patients, followed by 8 in 90 patients.
Bilobe nasal flaps were utilized in 60 patients and had a minimum score of 6 and a maximum of 10 with a mean of 8.533±0.911. The single composite graft used for repair of a full thickness alar defect had a score of 9. All the patients who had dorsal nasal and dorsal glabellar flaps had a score of 8. Hinge subcutaneous cheek flaps with skin grafts had a minimum score of 7 and a maximum score of 9 with a mean of 8.5±0.674. Transposition flaps had a minimum score of 8 and a maximum score of 10 with a mean of 9.095±0.436.
Interpolated cheek flaps performed in 54 patients had a minimum score of 6 and a maximum score of 9 with a mean of 7.963±0.868. Interpolated paramedian forehead flaps performed in 102 patients had a minimum score of 5 and a maximum score of 10 with a mean of 8.304±1.0224.
Conclusion:
We recommend using the paramedian forehead flap for nasal defects