J Rhinol.  2023 Mar;30(1):37-40. 10.18787/jr.2022.00426.

A Case of Forehead Flap Nasal Reconstruction for Dog Bite Nasal Injury

• Ryu SS
• Jang YJ

• KMID: 2540856
• DOI: http://doi.org/10.18787/jr.2022.00426

Abstract

A dog bite is the most common trauma among animal bites, and it has varying severity, from simple skin lacerations to defects in whole tissue layers. Considering the aesthetic and functional importance of the nose, an appropriate reconstruction should be conducted for large and full-thickness tissue defects. Although this is quite common, literature detailing surgical reconstruction is lacking, especially in domestic journals. A 45-year-old male patient visited an outpatient clinic due to nasal trauma caused by a dog bite. The patient’s nose showed whole-layer tissue defects, with necrotic tissues at the periphery. Nasal reconstruction surgery was conducted using a forehead flap and ear cartilage composite graft. Pedicle division was conducted three weeks after primary surgery. The functional and aesthetic outcomes of the surgery were satisfactory. Our experience demonstrates that the forehead flap is a useful option for reconstructing a nose badly injured by a dog bite.

Keyword

Dog bite; Acquired nasal deformities; Nasal surgery; Forehead flap

Figure

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  Fig. 1. Preoperative clinical photography. A: Frontal view. B: Basal view. C: Oblique view. D: Profile view. Upper 1/2 of columella of patient was destructed. Skin and cartilage portion of right lower lateral cartilage defects were identified. Left medial crus of lower lateral cartilage has necrotic tissue with atrophy.

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  Fig. 2. Image of reconstruction procedure, surgical field view, and postoperative clinical photography after forehead flap. A: Image of nasal reconstruction procedure. B: Surgical view of nasal reconstruction. C: Postoperative clinical photography after forehead flap nasal reconstruction. After reconstruction of bony, cartilage and right inner skin defect sites, soft tissue defect was reconstructed by forehead flap.

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  Fig. 3. Postoperative patient’s clinical photography. A: Frontal view—postoperative 6 months. B: Basal view—postoperative 1.5 months. C: Oblique view—postoperative 6 months. D: Profile view—postoperative 6 months. After reconstruction, patient showed successful nasal shape and function. Because the patient lived in Philippines, he sent photos 6 months after surgery and we can compare postoperative results with preoperative photos.

Reference

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