A Rotation Alar Fold Flap for Cosmetic Nasal Plane Reconstruction: Description of the Technique and Outcome in Three Dogs

SIMPLE SUMMARY: Cosmetic and functional outcomes are of great concern for nasal planum reconstruction, and the wishes of the owner in this regard may limit the extent of the excision and risk non-curative intent surgery. In veterinary medicine, several surgical techniques have been described, depending on the type, location, and extent of the tumor. In this study, a rotation alar fold flap technique is described and used in a short clinical case series following a subtotal or partial planectomy for oncological surgical purposes. No intraoperative and minor self-limiting post-operative complications were recorded, and the cosmetic and functional outcomes were considered very satisfactory in all cases. The rotation alar fold flap offers a valuable, feasible, functional, and aesthetically satisfactory alternative surgical option for selected cases of localized tumors involving the central and ventral planum. This technique, among others, can be used safely to improve the quality of life and the long survival time of our pets. ABSTRACT: Nasal planum reconstruction is a surgical challenge, and several surgical techniques have been described. The objective of this study was to describe the rotation alar fold flap technique and to report clinical outcomes in a short case series. The feasibility of the technique was first assessed in a canine cadaveric model. The rotation alar fold flap was obtained by a single sharp horizontal incision of the dorsolateral nasal cartilage, preserving the caudal mucosal attachment to the ventral nasal concha. The flap was then rotated ventro-medially for the reconstruction of the ventral aspect of the nasal planum unilaterally or bilaterally. The rotation alar fold flap technique was used following a subtotal or partial planectomy for excision of a squamous cell carcinoma or mast cell tumors in three dogs. No intraoperative complications were recorded. Superficial surgical site infection was reported in two cases and minor dehiscence was reported in one case. However, survival of the flap was not affected. The cosmetic and functional outcomes were considered very satisfactory in all cases. The rotation alar fold flap technique offers a safe, valuable, feasible, functional and aesthetically satisfactory alternative surgical option for selected cases of localized tumor involving the central and ventral planum.