garrigues - nasal reconstruction€¦ · nasal reconstruction ned garrigues, md, facs san diego,...

61
7/1/2014 1 Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California

Upload: others

Post on 24-Aug-2020

7 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

1

Nasal Reconstruction

Ned Garrigues, MD, FACS

San Diego, California

Page 2: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

2

Second Intent

• “Fester”

• Homograft

• Prosthesis

Second Intent

• “Fester”

• Homograft

• Prosthesis

Page 3: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

3

Second Intent

• “Fester”

• Homograft

• Prosthesis

Page 4: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

4

Second Intent

• “Fester”

• Homograft

• Prosthesis

Page 5: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

5

Direct Closure

Page 6: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

6

Page 7: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

7

Page 8: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

8

Page 9: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

9

Page 10: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

10

Skin Grafts

• Split Thickness

• Full Thickness

Skin Grafts

• Split Thickness

• Full Thickness

Skin Grafts

• Split Thickness

• Full Thickness

Page 11: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

11

Page 12: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

12

Page 13: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

13

Page 14: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

14

Page 15: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

15

Local Flaps

• Rhombic

• Bilobed

• Dorsal Nasal

Page 16: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

16

Local Flaps

• Rhombic

• Bilobed

• Dorsal Nasal

Page 17: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

17

Page 18: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

18

Page 19: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

19

Page 20: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

20

Page 21: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

21

Page 22: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

22

Local Flaps

• Rhombic

• Bilobed

• Dorsal Nasal

Page 23: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

23

Page 24: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

24

Page 25: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

25

Page 26: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

26

Page 27: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

27

Page 28: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

28

Page 29: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

29

Page 30: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

30

Page 31: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

31

Page 32: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

32

Local Flaps

• Rhombic

• Bilobed

• Dorsal Nasal

Page 33: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

33

Page 34: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

34

Page 35: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

35

Page 36: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

36

Regional Flaps

• Nasolabial

• Facial Island

• Forehead

Regional Flaps

• Nasolabial

• Facial Island

• Forehead

Page 37: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

37

Page 38: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

38

Page 39: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

39

Page 40: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

40

Page 41: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

41

Page 42: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

42

Page 43: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

43

Regional Flaps

• Nasolabial

• Facial Island

• Forehead

Page 44: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

44

Page 45: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

45

Page 46: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

46

Regional Flaps

• Nasolabial

• Facial Island

• Forehead

Page 47: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

47

Page 48: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

48

Page 49: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

49

Page 50: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

50

Page 51: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

51

Page 52: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

52

Page 53: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

53

Page 54: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

54

Page 55: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

55

Page 56: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

56

Page 57: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

57

Page 58: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

58

Page 59: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

59

Distant Flaps

• Free Tissue Transfer

Page 60: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

60

Page 61: Garrigues - Nasal Reconstruction€¦ · Nasal Reconstruction Ned Garrigues, MD, FACS San Diego, California. 7/1/2014 2 Second Intent • “Fester” • Homograft • Prosthesis

7/1/2014

61