The Use of Supratrochlear Artery Based Myofascial Forehead Flap for
Treatment of a Rhinophyma Case
Publication History:
Received: December 26, 2016
Accepted: September 20, 2017
Published: September 22, 2017
Keywords:
Rhinophyma, Forehead fap,
Supratrochlear artery
Case Report Open Access
Abstract
Rhinophyma is a disease going with subcutaneous tissue thickening of the nose, including sebaceous
gland hypertrophy and fbrosis. Progressive enlargement and irregular thickening of the nasal skin is
characteristic of the disease. Surgical excision is commonly used treatment method. In the present case,
nasal dorsal and alar defect afer treated with totally excision and full-thickness skin graf of rhinophyma
mass were repaired by using supratrochlear artery based myofascial forehead fap with a little skin island.
*
Corresponding Author: Dr. Umut Tuncel, Department of Plastic Reconstructive
and Aesthetic Surgery, Samsun Education and Research Hospital Samsun/
Turkiye, Tel: + 90532 724 9384; E-mail: drumuttuncel@gmail.com
Citation: Tuncel U, Gümüs M, Kurt A (2017) The Use of Supratrochlear Artery
Based Myofascial Forehead Flap for Treatment of a Rhinophyma Case. Int J
Surg Surgical Porced 2: 121. doi: https://doi.org/10.15344/2456-4443/2017/121
Copyright: © 2017 Tuncel. This is an open-access article distributed under the
terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author
and source are credited.
International Journal of
Surgery & Surgical Procedures
Umut Tuncel
*
, Murat Gümüs and Alper Kurt
Department of Plastic Reconstructive and Aesthetic Surgery, Samsun Education and Research Hospital Samsun/Turkiye
Int J Surg Surgical Porced IJSSP, an open access journal
ISSN: 2456-4443 Volume 2. 2017. 121
Tuncel, Int J Surg Surgical Porced 2017, 2: 121
https://doi.org/10.15344/2456-4443/2017/121
Special Issue: Plastic Surgery
Introduction
Rhinophyma is an extremely deformating condition of the nose and
considered to be the most severe expression of the fnal stage of acne
rosacea, which is characterized by a progressive painless hyperplasia of
the sebaceous glands and connective tissue of the nose [1]. Although
the etiology of rhinophyma is unknown, it is commonly believed to be
a severe end-stage of a skin condition known as rosacea [2,3].
Te supratrochlear artery based forehead fap has become
commonly preferred reconstructive option when dealing with
repairing large nasal defects [4-6]. Knowledge of the anatomical
course of the supratrochlear artery allows for more precise fap design,
greater mobility, and increased pedicle length [7].
We present a case treated with supratrochlear artery based
myofascial forehead fap along with full-thickness skin graf and
recommend this technique as a useful, safe, and efcient method for
the treatment of severe and moderate rhinophyma.
Patient and Method
A 50-year-old man presented with a 10-year history of progressive
bulbous overgrowth of the nose. He had a history of cystic acne as
a teenager. Te man had never undergone any laser or surgical
interventions and the nose kept slowly enlarging. No other medical
problem was reported, and there was no family history of rosacea.
Nodulocystic and scarred areas, also large dilated pores on the cheeks
were observed on the physical examination. Te nose was composed
of an exophytic bulbous mass with obliteration of the normal nose
contour (Figure 1). Te rhinophyma mass was completely excised and
the defect was repaired by a full-thickness skin graf. However, skin
graf on the nasal dorsum was showed to be necrosis afer the surgery
(Figure 2). A supratrochlear artery based myofascial forehead fap
along with full-thickness skin graf was planned to close the defect.
Also, a skin island at tip of the myofascial fap was planned for the
reconstruction of nasal alar defect.
Te procedure was performed under general anesthesia. Te
wound was debrided and a subcutaneous paramedian forehead fap
was designed according to the size of defect area on the nasal dorsum
and nasal ala. Before the fap was raised, supratrochlear artery was
dissected on the location about 2 cm lateral to the midline near the
medial eyebrow and the fap pedicle of approximately 1 cm width was
Figure 1: preoperative view of the patient.
Figure 2: rhinophyma mass was totally excised and treated
by skin grafing, but full-thickness defect was showed on the
nasal dorsum due to the skin graf necrosis.