Inferiorly-Hinged Transnasal Advancement Flap with Back-Cut for Medial Canthal Reconstruction: A Case Series?
Author: Sarala Joshi
Base Hospital / Institution: Queen Victoria Hospital
ePoster presentation
Abstract ID: 25-543
Purpose
We present variations of the inferiorly-hinged transnasal advancement flap, augmented with an inferior back-cut, as a versatile option for medial canthal defect reconstruction. Its utility and modifications help minimise visible scars by concealing incisions behind the nasal bridge of spectacles. Despite being described over a decade ago, it remains underutilised or widely recognised in routine practice.
Methods
Retrospective case series of 6 patients with medial canthal basal cell carcinoma undergoing frozen section-controlled excision and reconstruction using this flap technique. Surgical modifications included size of flap and back-cuts to enhance flap mobility. Outcomes included Strasser grading using post-operative photographs, and complications.
Results
All defects were reconstructed successfully, with scars concealed (Strasser graded) and no major complications. Follow-up showed excellent functional and aesthetic results.
Conclusion
This report highlights the versatility of the inferiorly-hinged transnasal advancement flap as a valuable first-line option for medial canthal defects not amenable to direct closure or laissez-faire. Modifications include avoiding scars extending to the glabella and remaining concealed with spectacle wear.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Anthony | Yao | Queen Victoria Hospital |
| Raman | Malhotra | Queen Victoria Hospital |
