The hinged-door composite septal flap as structural support and lining of nasal reconstruction by a forehead flap

In this paper we describe four patients who underwent extensive nasal surge ry for carcinoma in the nasal vestibule. Two patients underwent salvage sur gery after radiotherapy, whereas the other two patients were treated with p rimary surgery. In all cases the nasal defect was reconstructed using a com posite hinged-door septal flap for structural support and internal lining c ombined with a paramedian forehead flap which supplied the skin coverage. A ll patients had a pleasing aesthetic and good functional result. The combin ation of a paramedian forehead flap with a composite hinged-door septal fla p is an excellent reconstruction procedure for defects of the lateral nasal wall and alar region.