Aesthetic and Functional Evaluation of Total Nasal Reconstructions

The loss of a portion or the totality of the nose has great relevance on the perception of the beauty of a face and can result in a catastrophic quality of life impairment. Several surgical techniques are currently available for the reconstruction of the nasal pyramid, but there are very few nasal reconstruction quality evaluation protocols that allow the surgeon to objectively choose the best technique for each kind of defect. Six total nasal reconstructions performed at the University of Sassari Maxillofacial Unit were evaluated with a protocol investigating objectively and subjectively the surgical aesthetic and functional outcome; sensitivity recovery on the reconstructive flaps was also assessed. Patients reported a satisfactory nasal reconstruction both functionally and aesthetically. Sensitivity recovery on the forehead flap was always present, even after pedicle resection or in case of traumatic section of the infraorbital nerve. The use of a three-layer reconstruction has proved a viable technique both aesthetically and functionally: in particular, the use of the forehead flap to reconstruct the outer layer of the nose allows carrying a tissue with characteristics very similar to the original, with a recovery of sensitivity that is almost complete.