Trans-flap nasal airway preservation in-house device.

Reconstruction of the nasal pyramid following oncologic ablative surgery presents a unique set of challenges due to the region's intricate anatomy and dual functional and aesthetic significance. In cases where immediate nasal reconstruction is not feasible, maintaining nasal airway patency becomes critical for patient safety and postoperative outcomes. This technical note introduces a practical method for modifying and utilizing Naso-Flo® nasal intubation tubes as a nasal airway preservation device in reconstructive surgeries involving microvascular flaps. The technique ensures the preservation of nasal airflow through both nasal cavities by channeling two nasal tubes through the flap during reconstruction. The procedure begins with preoperative planning to measure the nasal cavities and design the flap while identifying safe zones for tube placement, avoiding vascular perforators. During flap inset, pathways are created through the flap's thickness to accommodate the nasal tubes, which are securely positioned and sutured externally. This device provides an alternative airway until secondary reconstructive surgeries are performed, with adjustable trimming during follow-up. This in-house modification demonstrates an efficient, cost-effective solution to preserve nasal airway patency, offering functional and safety benefits in complex nasal reconstructions where staged procedures are required.