OBJECTIVE: To report a new technique using a bivalved, full-thickness paramedian forehead flap. The unique vascular anatomy of the supratrochlear artery allows the skin and subcutaneous tissue to be separated from the frontalis muscle and pericranium. The deep layers serve as a pliable, vascularized intranasal lining. Bone and cartilage grafts can be placed as "sandwich" grafts between the deep and superficial layers of the flap. STUDY DESIGN: A retrospective review of 5 cases. All flaps survived. Four minor complications occurred in 3 patients. These resolved with minimal treatment. CONCLUSIONS: The full-thickness forehead flap is a viable option for large defects or for the difficult situation in which intranasal local flaps are not an option. SIGNIFICANCE: The gold standard for replacement of the intranasal lining is a septal mucosal or vestibular local flap. The full-thickness forehead flap is an option in patients for whom other lining flaps are not available. EBM rating: C-3.
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