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<p>Reconstructing nasal defects exceeding 1.5&#xa0;cm presents a significant surgical challenge. Comparative studies of single versus staged reconstruction are lacking. This review examines a single-center experience with nasal defects 1.5&#xa0;cm or larger by comparing aesthetic and functional outcomes in local versus interpolation flaps while evaluating potential prognostic and associated risk factors. This retrospective chart review was performed on patients undergoing repairs of Mohs surgery (MMS) defects of the nose over a period from January 01, 2019 to September 01, 2024. Patient, tumor, Mohs characteristics and presence of co-morbidities were collected. Two independent blinded dermatologist raters assessed outcomes using the Patient and Observer Scar Assessment Scale (POSAS). Assessment of scar vascularity, pigment, pliability, relief, thickness and surface area of 202 patients by 2 independent reviewers yielded an overall cosmesis score of 12.1(4.6) (out of 60) in the interpolation cohort versus 12.1(4.0) in the local flap cohort for reviewer 1 and 15.7(3.4) versus 15.6(4.0) for reviewer 2. 11 complications were noted. No differences were seen when analyzed by small defects (1.5–2.0&#xa0;cm), medium (2.0–2.5&#xa0;cm) or large defects (&gt; 2.5&#xa0;cm). Hypertension was more prevalent in the higher POSAS categories (<i>p</i> = 0.011), OR 3.50, CI 1.38–8.90, <i>p</i> = 0.012. There was no statistically significant difference in cosmetic or functional outcomes observed between interpolation and local flaps in the reconstruction of nasal defects ≥ 1.5&#xa0;cm. An individualized approach should be taken and local flaps should be considered as appropriate to optimize reconstructive outcomes and patient satisfaction.</p>

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A retrospective study comparing aesthetic and functional outcomes in Mohs surgery between local flaps and interpolation flaps in nasal defects greater than 1.5 cm

  • 期刊论文

  • 发表日期：

    2026年6月18日

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  • Igor Kapetanovic,
  • Adam Mattox,
  • Jessica Padniewski,
  • Rick J. Jansen,
  • Ian Maher

摘要

Reconstructing nasal defects exceeding 1.5 cm presents a significant surgical challenge. Comparative studies of single versus staged reconstruction are lacking. This review examines a single-center experience with nasal defects 1.5 cm or larger by comparing aesthetic and functional outcomes in local versus interpolation flaps while evaluating potential prognostic and associated risk factors. This retrospective chart review was performed on patients undergoing repairs of Mohs surgery (MMS) defects of the nose over a period from January 01, 2019 to September 01, 2024. Patient, tumor, Mohs characteristics and presence of co-morbidities were collected. Two independent blinded dermatologist raters assessed outcomes using the Patient and Observer Scar Assessment Scale (POSAS). Assessment of scar vascularity, pigment, pliability, relief, thickness and surface area of 202 patients by 2 independent reviewers yielded an overall cosmesis score of 12.1(4.6) (out of 60) in the interpolation cohort versus 12.1(4.0) in the local flap cohort for reviewer 1 and 15.7(3.4) versus 15.6(4.0) for reviewer 2. 11 complications were noted. No differences were seen when analyzed by small defects (1.5–2.0 cm), medium (2.0–2.5 cm) or large defects (> 2.5 cm). Hypertension was more prevalent in the higher POSAS categories (p = 0.011), OR 3.50, CI 1.38–8.90, p = 0.012. There was no statistically significant difference in cosmetic or functional outcomes observed between interpolation and local flaps in the reconstruction of nasal defects ≥ 1.5 cm. An individualized approach should be taken and local flaps should be considered as appropriate to optimize reconstructive outcomes and patient satisfaction.