Tipton suggested using the Nelaton flap for larger defects in 1975. The ala is detached for its full thickness, and the Nelaton flap is sutured into the defect (Fig. 5.58a). The upper edge of the flap can be deep-ithelialized prior to inset. The second side can be left to granulate. Three weeks later the flap is detached and the ala returned to its original position (see Fig. 5.47).
Fig. 5.57a Posteriorly (or anteriorly) based flap from the inferior turbinate (may include a piece of bone).
b Meyer's intraoral mucosal flap. The flap is precut and prelined with a cartilage graft. Two weeks later it is delivered through a tunnel to the nasal septum. The wound is closed in two layers, and the flap is detached at 3 weeks.
Fig. 5.58 Nasolabial flap a The ala is detached, and the Nelaton flap is raised. b The Nelaton flap is swung into the septal defect and inset, and the ala is returned to its original position and sutured into place. (In a second stage the flap is detached and the alar groove is closed.)
Was this article helpful?