Defect closure in the paranasal region: an enduring challenge

Background The paranasal region constitutes a demanding issue for the reconstructive surgeon. Its complex anatomy, with concavity in close contact with convexity, and a high density of functional and aesthetically important facial components demands specific concern. Due to such complexity, numerous procedures for the reconstruction of paranasal defects have been published, including skin grafts and flaps in random pattern or axial style from the glabella, upper lid, nasal root, or cheek. Objectives In this review, we recall classical reconstructive procedures and compare them with innovative procedures that could possibly gain importance in the following years. Methods We contrast the pros and cons concerning donor site morbidity, surgical elaborateness, and functional and aesthetic outcome, and substantiate our findings with photographic results from our own patient material. Results and Conclusion The reconstruction of paranasal defects remains a challenge; nevertheless, the growing toolbox of reconstructive instruments facilitates a perfect reconstructive result.