Total loss of columella causes significant aesthetic and functional deformities due to its important functions which provides assistance and extension to the nose pointer. Noma is described as one of the developed sources of total columellar loss, and is also contagious, with the ability to intensely damage facial tissues and immediate structures. However, the condition is predominantly suffered in Africa, with an estimation of 20 instances per 100,000 individuals. Furthermore, the reformation of a columellar disorder offers a complex process, due to the structural features of the location. A 24-year-old female patient with total columellar loss caused by Noma. We performed a two stage reconstruction. First, we used double nasolabial flaps to create a new columella. Second, we inserted costal cartilage and dermofat graft to support it. The double nasolabial flap demonstrated 100% survival. Both nasal airway and the final appearance showed functionally and cosmetically remarkable results. The nasolabial angle projected better than the preoperative measurement. The patient was satisfied. The patient was followed up until a year after surgery. The double nasolabial flaps combined with costal cartilage graft is one of the best surgical options to obtain astonishing columellar reconstruction.
Objective: To report on the result of nonsurgical correction of deformational auricular anomaly (cryptotia) using moulded silicone as a splint. Methods: Congenital auricular anomalies can be categorized as either malformed or deformational. Cryptotia as a deformational anomaly is defined as an ear having normal chondrocutaneous components with an abnormal architecture; therefore, it can be manipulated digitally into normal shape. Auricular deformation commonly affect the helix and antehelix. Since neonatal auricle is extremely pliable, we used early splinting to correct deformational ear anomalies. These splints are made from silicone, moulded into a small bar and held in place with the Steri-Strips™. The type of the auricular anomaly was documented both clinically and photographically before and two months after the cessation of treatment. Assessment of the result was made by comparing the pre- and post-treatment photograph. Result: In this case report, we applied this method to two newborn with cryptotia and the correction was achieved completely in two months after application of the silicone bar. The parents felt that auricular splinting is worthwhile. Conclusion: Deformational congenital auricular anomaly can be corrected nonsurgically using splinting therapy. The treatment is effective if initiated in the first three months of life. Patients and parents persistence is essential to reach satisfactory outcome. Adherence to treatmenr is crucial to negate the need for surgical treatment of congenital auricular anomalies.
Introduction : Nicotine was assumed to be the cause of compromised flap. The administration of antioxidants can eliminate such effect, and one of the most promising antioxidants is Coenzyme Q10. The research aims to find the effect of orally administered Coenzyme Q10 on the viability of random skin flaps in nicotine-exposed wistar rats. Method : Twenty-seven white rats (Rattus norvegicus) were assigned in three groups. The first group received no nicotine, while the other two groups were nebulized with nicotine for 4 consecutive weeks, and treated as random skin flaps. In third group, Coenzyme Q10 was administered for 7 days. Then, a standard histopathological staining and vascular endothelial growth factor (VEGF) measurement were performed on flap sample to examine the extent of neovascularization and VEGF cell expression. Result : The average number of capillaries in group I was 5.33 ± 1.323, in group II was 5.89 ± 0.782, and in group III was 7.78 ± 2.587. There was no significant difference (p = 0.317, 95% CI) in groups I and II of VEGF expression. However, significant differences were found in the intensity of VEGF (p = 0.009, 95% CI) in groups I and group III, and in groups II and group III (p = 0.011, 95% CI). Thus, the intensity was stronger on the subject with coenzyme Q10 compared with the other two groups. Conclusion: Coenzyme Q10 increases the viability of random flaps by increasing the number of capillaries and VEGF expression.
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