Abstract
Restoring nasal lining is one of the essential parts during reconstruction of full-thickness
defects of the nose. Without a sufficient nasal lining the whole reconstruction will
fail. Nasal lining has to sufficiently cover the shaping subsurface framework. But
in addition, lining must not compromise or even block nasal ventilation. This article
demonstrates different possibilities of lining reconstruction. The use of composite
grafts for small rim defects is described. The limits and technical components for
application of skin grafts are discussed. Then the advantages and limitations of endonasal,
perinasal, and hingeover flaps are demonstrated. Strategies to restore lining with
one or two forehead flaps are presented. Finally, the possibilities and technical
aspects to reconstruct nasal lining with a forearm flap are demonstrated. Technical
details are explained by intraoperative pictures. Clinical cases are shown to illustrate
the different approaches and should help to understand the process of decision making.
It is concluded that although the lining cannot be seen after reconstruction of the
cover it remains one of the key components for nasal reconstruction. When dealing
with full-thickness nasal defects, there is no way to avoid learning how to restore
nasal lining.
Keywords
nasal lining - full-thickness nasal defects - nasal reconstruction
