Two Cases of Nasal Wing Reconstruction with Composite Tissue Graft from the Auricle

Abstract

Case 1 :A 79-year-old male came to our department because of a small nodule on the right nasal wing. Although the time of onset was unknown, it was noted to gradually increase in size. At the time of initial examination, an erythematous nodule with a central crust of 6 mm in diameter was observed on the right nasal wing. Case 2 :An 83-year-old male who had been aware of a small nodule on the left nasal wing for the past six months, which gradually increased in size, was referred to our department by his family doctor. A black nodule with hemorrhage was observed on the left nasal wing with a diameter of 10 mm. Partial biopsy revealed squamous cell carcinoma in Case 1 and basal cell carcinoma in Case 2, and both were resected under local anesthesia. The resected defect was reconstructed using a composite tissue graft containing cartilage from the auricle. The color tone of the composite tissue graft changed dynamically postoperatively. The color change may be related to its biosorption mechanism. The size of the composite tissue graft in the autopsy case was relatively large compared to other cases reported in the past. In Case 2, the graft showed partial necrosis and general hyperpigmentation ; however, it remained viable. In the present cases, we used a local anesthetic containing epinephrine. Although it is not frequently used as its vasoconstrictive effect may prevent graft implantation, in our cases, its hemostatic effect may have facilitated the surgical operation and allowed the graft to be harvested easily. In addition,chondrocutaneous advancement flap reconstruction is a helpful method because it is possible to reconstruct even relatively large auricular defects, and it is not a complicated procedure. Skin Research, 21 : 219-225, 2022