The Koomas of ancient India, members of the caste of potters, tad developed the art of reconstructing the destroyed nose by means of a forehead flap, a method often referred to as the Indian method and described in the writings of Sushruta. The skin of the forehead has the same advantages in general as that of the nasolabial fold and cheek in nasal reconstruction as it provides a close color and texture match. A midline forehead flap is a good one for the repair of the nasal defects because it requires few stages, is easy to transfer, is convient for the patient, ana produces neither mutilation nor disturbance of the normal wrinkling of the forehead. The flap has a gooa tlood supply from the paired supratrochlear vessels of both sides.
The midline island forehead flap with the subcutaneous pedicle differs from the ordinary midline forehead flap by the absence of the usual pedicle of the skin. The island flap provides greater mobility than other type of the forehead flaps because the subcutaneous pedicle is more readily twisted and the skin flap is more easily adjusted into the recipient site. A second appreciable advantage of the island flap is that only one stage is required.
Dhawan designed a rather oblique forehead flap situated off the midline, base4 on a single supratrothlear artery. This departure from the midline flap adds to the length, but it produceson oblique forehead scar which may be more prominent and thus less acceptable. Nevertheless, if the flap is based on one vessel, the protrusion at the root of the nose as a result of the presence of the subcutaneous pedicle will become less prominent than the flap based on bilateral vessels. Moreover the motility of the flap with one vessel is much greater than the previous island flap. While retaining the advantage of a midline scar, author hate use4 an midline island forehead flap based on a single supratrochlear artery for the reconstruction of various nasal defects. This paper deals with my experience with such a flap in 5 patients.
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