RSS-Feed abonnieren
PDF herunterladen
DOI: 10.1055/s-0045-1809054
Medial Femoral Condyle Flap for Nasal Support in Cocaine-Induced Midline Destruction
Abstract
Prolonged cocaine use can severely damage the osteocartilaginous structures of the midface region. Involvement of the nose, sinuses, and palate has been grouped into a syndrome called cocaine-induced midline destructive lesions. These lesions may resemble other necrotizing conditions, often complicating diagnosis and treatment. A complex nasal reconstruction is introduced in a 54-year-old woman with extensive midfacial destruction after 15 years of cocaine abuse. Total nasal reconstruction was performed using a medial femoral condyle free flap (MFCFF) for internal lining and bone support in combination with a paramedian forehead flap for external coverage. The MFCFF proved to be effective in recreating the anatomy of the nasal dorsum with minimal donor site morbidity, while the paramedian forehead flap improved the aesthetic results. Despite the need for multiple surgical interventions, this approach showed satisfactory functional and aesthetic long-term results.
Publikationsverlauf
Artikel online veröffentlicht:
13. Mai 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Colletti G, Autelitano L, Chiapasco M. et al. Comprehensive surgical management of cocaine-induced midline destructive lesions. J Oral Maxillofac Surg 2014; 72 (07) 1395.e1-1395.e10
- 2 Trimarchi M, Gregorini G, Facchetti F. et al. Cocaine-induced midline destructive lesions: clinical, radiographic, histopathologic, and serologic features and their differentiation from Wegener granulomatosis. Medicine (Baltimore) 2001; 80 (06) 391-404
- 3 Howard BE, Patel S, Shockley WW, Clark JM. Total nasal reconstruction: advances in free tissue transfer for internal lining and structural support. Facial Plast Surg Clin North Am 2024; 32 (02) 247-259
- 4 Brusati R, Carota F, Mortini P, Chiapasco M, Biglioli F. A peculiar case of midface reconstruction with four free flaps in a cocaine-addicted patient. J Plast Reconstr Aesthet Surg 2009; 62 (02) e33-e40
- 5 Salibian AH, Menick FJ, Talley J. Microvascular reconstruction of the nose with the radial forearm flap: a 17-year experience in 47 patients. Plast Reconstr Surg 2019; 144 (01) 199-210
- 6 Sakai K, Doi K, Kawai S. Free vascularized thin corticoperiosteal graft. Plast Reconstr Surg 1991; 87 (02) 290-298
- 7 Del Piñal F, García-Bernal FJ, Regalado J, Ayala H, Cagigal L, Studer A. Vascularised corticoperiosteal grafts from the medial femoral condyle for difficult non-unions of the upper limb. J Hand Surg Eur Vol 2007; 32 (02) 135-142
- 8 Gaggl AJ, Bürger H, Chiari FM. Reconstruction of the nose with a new double flap technique: microvascular osteocutaneous femur and microvascular chondrocutaneous ear flap–first clinical results. Int J Oral Maxillofac Implants 2012; 41 (05) 581-586
- 9 Cherubino M, Stocco C, Tamborini F. et al. Medial femoral condyle free flap in combination with paramedian forehead flap for total/subtotal nasal reconstruction: level of evidence: IV (therapeutic studies). Microsurgery 2020; 40 (03) 343-352
- 10 Ismail T, Kurlander DE, Lee ZH. et al. The medial femoral condyle flap: a novel versatile tool for complex microvascular maxillofacial reconstruction. Plast Reconstr Surg 2023; 151 (01) 115e-119e