Facial plast Surg 2017; 33(01): 052-057
DOI: 10.1055/s-0036-1593747
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Titanium Mesh Nasal Repair without Nasal Lining

Joseph Zenga1, Katherine Kao1, Collin Chen1, Jennifer Gross1, Samuel Hahn2, John J. Chi1, Gregory H. Branham1
  • 1Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, Saint Louis, Missouri
  • 2Department of Otolaryngology, ENT Associates at GBMC, Baltimore, Maryland
Further Information

Publication History

Publication Date:
22 February 2017 (online)

Abstract

The objective of this study was to describe outcomes for patients who underwent titanium mesh reconstruction of full-thickness nasal defects without internal lining repair. This is a retrospective cohort study. Patients with through-and-through nasal defects were identified at a single academic institution between 2008 and 2016. Nasal reconstruction was performed with either titanium mesh and external skin reconstruction without repair of the intranasal lining or traditional three-layer closure. Five patients underwent titanium mesh reconstruction and 11 underwent traditional three-layer repair. Median follow-up was 11 months (range, 2–66 months). The only significant difference between groups was older age in patients undergoing titanium reconstruction (mean, 81 vs. 63 years; difference of 18; 95% confidence interval [CI], 4–32 years). Defect extent including overall size and structures removed was similar between groups (p > 0.05). Paramedian forehead flap was the most common external reconstruction in both groups (100% for titanium mesh and 73% for three-layer closure). Time under anesthesia was significantly shorter for titanium mesh reconstruction (median, 119 vs. 314 minutes; difference of 195; 95% CI, 45–237). Estimated blood loss and length of hospital stay were similar between groups (p > 0.05). Complication rates were substantial although not significantly different, 40 and 36% in titanium and three-layer reconstruction, respectively (p > 0.05). All patients with complications after titanium reconstruction had prior or postoperative radiotherapy. Titanium mesh reconstruction of through-and-through nasal defects can successfully be performed without reconstruction of the intranasal lining, significantly decreasing operative times. This reconstructive technique may not be suitable for patients who undergo radiotherapy.