Reconstruction of the ala nasi and the lateral wall of the nose.

With reference to the functional importance of the vestibular region, it is recommended that only such operative methods should be practiced for the reconstruction of the ala nasi as take into account the aerodynamics of the vestibular region. The reconstruction of the cartilaginous infrastructure should therefore be an integrading component of the ala replacement. Various possibilities for the fulfilling of these requirements are pointed out and a pedicled septal mucosa-skin-cartilage flap described by the author which, in conjunction with a frontal skin flap permits the repair of the ala nasi in a shorter time is described in more detail. For the treatment of defects of the lateral nasal wall, in addition to the insular flap operation from the nasolabial region and the forehead, the medial frontal flap technique as described by Kazanjian is particularly recommended. This method is also suitable very particularly for closure of perforating defects in conjunction with the split skin graft.