0
Original Article |

Full-Thickness Skin Graft Overlying a Separately Harvested Auricular Cartilage Graft for Nasal Alar Reconstruction

David A. Zopf, MD; Wade Iams, MD; Jennifer C. Kim, MD; Shan R. Baker, MD; Jeffrey S. Moyer, MD
JAMA Facial Plast Surg. 2013;15(2):131-134. doi:10.1001/2013.jamafacial.25.
Text Size: A A A
Published online

Objective  To evaluate the aesthetic and functional outcomes of a full-thickness skin graft and a separately harvested auricular cartilage graft for nasal alar defects created by Mohs micrographic surgery.

Design  Twenty patients with deep Mohs micrographic surgery defects of the nasal ala who underwent reconstruction with a full-thickness skin graft and an auricular cartilage graft were prospectively studied at a single tertiary care institution between 2010 and 2011 in a nonrandomized, nonblinded study. An ordinal 5-point Likert scale evaluation of overall outcomes was performed by 4 independent surgeon raters.

Results  The mean outcome for use of the full-thickness skin and auricular cartilage graft construct was a score of 2.3 on a scale of 1 through 5, with 1 being excellent and 5 being poor. The mean duration of follow-up was 6 months, with a range of 5 weeks to 23 months. There were no clinically meaningful losses of constructs in the patients studied.

Conclusion  A full-thickness skin graft and a separately harvested auricular cartilage graft are valuable and reliable tools for reconstructing deep nasal alar defects that require support to prevent alar retraction or collapse, particularly when a single-stage procedure is preferred or necessary because of medical comorbidities.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Place holder to copy figure label and caption
Grahic Jump Location

Figure 1. Full-thickness skin graft and separately harvested auricular cartilage graft technique for mucosal-sparing nasal alar defects. A, Nasal alar Mohs defect. B, Outlined area of lateral undermining. C, Typical auricular cartilage graft dimensions and positioning with overlying full-thickness skin graft placement.

Place holder to copy figure label and caption
Grahic Jump Location

Figure 2. Surgeon Likert rating value frequency (1, excellent; 2, very good; 3, good; 4, fair; and 5, poor).

Place holder to copy figure label and caption
Grahic Jump Location

Figure 3. Full-thickness skin graft overlying a separately harvested auricular cartilage graft used to reconstruct a right lateral nasal alar defect. A, Pre-Mohs resection. B, Post-Mohs resection prereconstruction. C-E, Twenty-two months after reconstruction: lateral view (C), oblique view (D), and frontal view (E) (mean rating, 2.5).

Place holder to copy figure label and caption
Grahic Jump Location

Figure 4. Full-thickness skin graft overlying a separately harvested auricular cartilage graft used to reconstruct a large, rim-sparing, nasal alar defect. A, Post-Mohs resection prereconstruction. B-E, Six months after reconstruction: frontal view (B), lateral view (C), oblique view (D), and basal view (E) (mean rating, 3.5).

Place holder to copy figure label and caption
Grahic Jump Location

Figure 5. Mucosal-sparing alar defect reconstructive guide. FTSG indicates full-thickness skin graft.

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs