An Algorithm for Treatment of Nasal Defects

Nasal defects are common after cancer resection, and the goal of treatment is to appropriately define the defect and then to select the best reconstructive options. The plastic surgeon must reestablish all deficient layers of the nose (support, lining, and external cover). The authors' algorithm is based on defect location and orientation, with the nose divided transversely into three zones, and then into subunits. In this article, using the aforementioned algorithm, the authors simplify the complex topic of nasal reconstruction, concentrating on local and regional flap reconstruction. The appropriate treatment for full-thickness defects, including options for reconstruction of lining and support, is also discussed.