Nasal defects can be congenital but are mostly caused by trauma or cancer. Nasal reconstruction of these defects requires meticulous planning with attention to both function and esthetics. A few basic principles of nasal reconstruction should always be observed:
The design of the subunits to be reconstructed can be based on the contralateral subunits, if still present. A template is made to reconstruct the defect and should neither be too big or too small, as this will lead to distortion and asymmetry of the nose. A 3D template is made based on the remaining nose. The subunit borders are marked with a pen and covered with small pieces of tape in a criss-cross way. The ink will adhere to the tape, which can be removed as a mold. Excess tape is trimmed. This 3D mold is then converted to a 2D template by making small radial cuts. It is then reversed, as it represents the contralateral normal side (Figure 2), and used to design the forehead flap dimensions. This process is done at the beginning of the reconstruction and is time consuming. When there is no contralateral normal as reference, basic anthropometric dimensions can be used or the defect can be sculpted with wax to mimic the reconstructed nose, which is then used to create a template.
The goal of this thesis is to work on developing a virtual surgical planning tool for soft tissue reconstructions of the nose. This virtual planning could be achieved by developing a software tool and graphical user interface to design templates of the nasal subunits that need to be reconstructed based on 3D photography or previous facial CT or MRI scans of the patient. An algorithm should then be applied to convert the 3D design to a 2D template, which can be used for the design of the forehead flap. This will offer the reconstructive surgeon many advantages: