NASAL RECONSTRUCTION IN CHILDREN - A REVIEW OF 29 PATIENTS

Acquired large nasal defects are much more common in adulthood than in childhood because of the frequency of skin tumors after a certain age . However, from their experience in treating a number of children with sequelae of noma and burns, the authors have collected a series of 17 total and 12 partial nasal reconstructions in children aged 1 to 15 y ears. After reviewing the various methods used for recreating the lini ng, the support, and the skin cover in the whole series, three cases a re reported in detail. A 1-year-old patient received a tempororetroaur icular flap after total amputation of the nose and was observed for 17 years. Another patient, who was burned as a baby, underwent reconstru ction at age 10 with a deltopectoral flap and was observed for 7 years . The third patient underwent total nose reconstruction at age 12 with an Indian forehead flap. From their experience, the authors conclude that, for psychosocial reasons, nasal reconstruction should be started early, despite possible reoperation at a later age. The best results are certainly obtained at the end of growth or at least after the age of 12. Adjacent bone or soft tissue defects further enhance the diffic ult challenge of restoring a satisfactory aesthetic appearance in thes e children.