L-Shaped Septal Chondromucosal Flap

D. R. MILLARD JR.

Nasal reconstruction requires the provision of support, as well as cover and lining (1). When the support normally provided by the septum has been lost, an L-shaped septal chondromucosal flap usually can be advanced from remaining septum. It can then be lifted out of the nasal cavity, so that its front prow rests on the nasal spine area, and it can be fixed at this point (2).

FIGURE 69.1 The remaining septum is marked and cut as an L-shaped chondromucosal flap based superiorly. The chisel is seen freeing the anterior portion of the flap from the vomerine groove. The broken line at the base of the L (toward the dorsal tip of the nasal bones) is the area where the cartilage can be divided subperiosteally if release is needed.