Nasal columella reconstruction – A comprehensive review of the current techniques

Nowicki, Jake; Abbas, Jonathan R.; Sudbury, Danny; Anari, Shahram

doi:10.1016/j.bjps.2020.01.016

Cited by 16 publications

(39 citation statements)

References 63 publications

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“…The reconstructed columella should be narrow to provide optimal passage of air and should have a suitable height to provide adequate support and projection to the tip [4] . Various surgical techniques have been described in columellar reconstruction including full thickness skin grafts, composite grafts, local and regional flaps, as well as free flaps [5] . The surgical approach is determined by the extent and depth of the defect, local anatomy and quality of surrounding tissue.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of columella and nasal vestibuli by bilateral nasolabial flaps – A case report

Krogerus

Demant

Lindskow

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance The nose is a common location for non-melanoma skin cancers. Resection of such cancers can result in large, multilayer defects that are challenging to reconstruct. The surgical approach is determined by multiple factors and the main goal is to obtain a satisfactory functional and aesthetic result. We present a case of reconstruction of the nasal vestibuli and columella by two transnasal nasolabial flaps. Presentation of case A 66-year-old male underwent resection of a large squamous cell carcinoma in the right nasal vestibulum that extended through the columella into the left vestibulum. The resection resulted in a multilayer defect including the floor and roof of the right vestibulum, the entire columella, part of the septum cartilage and floor of the left vestibulum. The defect was reconstructed in two stages by bilateral nasolabial flaps, that were brought into the nasal cavity through incisions on the side of the nose and were used to line the vestibuli and sutured to each other medially to form the neocolumella. No complications or surgical site infections were observed. Clinical discussion Transnasal nasolabial flaps can be used for larger columellar defects. The length of the flaps in our case provided enough tissue to reconstruct the columella as well as the entire vestibular linings. Conclusion We describe a successful reconstruction of the nasal vestibuli and columella with two transnasal nasolabial flaps, which provided an acceptable aesthetic and functional result.

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Section: Discussionmentioning

confidence: 99%

“…Nasolabial flaps have been frequently used for larger columellar defects. It is a well vascularized flap with a good colour and texture match and subtle donor site scarring [5] . In our case the defect was composed of not only the columella, but the lining of the nasal vestibulum on both sides.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of columella and nasal vestibuli by bilateral nasolabial flaps – A case report

Krogerus

Demant

Lindskow

et al. 2022

International Journal of Surgery Case Reports

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“…One of the local flap techniques is the perialar rim flap that standard alar rim flap reconstruction involves marking the bilateral alar margin flaps medially based on thenasal tip. The surgical approach to the reconstruction of a columella defect is influenced by the local anatomy, the patient's health, the extent and depth of the defect and the character of the remaining tissue surrounding the defect (Nowicki et al, 2020). The patient then underwent surgical management of the columella of bilateral perialar flap on 23th -Nov -2021 (Figure 3).…”

Section: Introductionmentioning

confidence: 99%

Perialar Flap Reconstruction Technique Approach of Nasal Columellar Dehiscence Post Trauma Continuous Positive Airway Pressure (CPAP)

2023

JPTCP

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Introduction: Continuous positive airway pressure (CPAP) is often used in neonates with respiratory distress. However, long-term use of CPAP can cause columella necrosis. This mechanism results from a pressure injury or shear force when the device is applied to the nose. Techniques of columella reconstruction has its indications, advantages and disadvantages. Case: A 9-year-old girl came with anterior nasal aseptum. The patient was born prematurely with a gestational age of 6 months. The patient then received ICU Treatment for Respiratory Distress Syndrome due to prematurity with CPAP for 3 months. The patient finished therapy but came home with a columella defect. On the Multi Slice CT-Scan examination, soft tissue defect columella were seen. The patient then underwent columella reconstruction surgery with the dextra et sinistra perilar flap technique. Conclusion:Long-term use of CPAP increases the risk of columella injury. There is a need for both a preventive approach to the CPAP adhesion site in the nose to prevent further nasal injury and appropriate management of this injury. Columella reconstruction technique in the form of perialar flap technique in patients has satisfactory results.

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“…To our knowledge, there has been no reported algorithm to specifically regulate columella reconstruction. The appropriate procedure therefore needs to be individualized to the patient in every case [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…The primary aim of the reconstructive surgery reported here was to preserve the aesthetic features of the face [ 1 , 4 ]. Such case reports remain rare and research into surgical techniques that can deliver satisfactory results are ongoing.…”

Section: Introductionmentioning

confidence: 99%

Nasal reconstruction surgery after continuous positive airway pressure delivered by prongs: A case report

Windura

Josh

Soekamto

et al. 2021

Annals of Medicine and Surgery

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Introduction and importance Deformities resulting from nasal continuous positive airway pressure delivered using prongs can cause functional and aesthetic issues for patients. Resultant severe tissue damage to the nasal structures often requires surgical intervention and techniques continue to evolve. Case presentation This case report describes a 6-year-old male presenting with a full-thickness columella defect; contracture causing deformities involving the nasal tip, ala nasi, and left nasal cavity wall; missing left lateral-medial cruris cartilage; and partially missing right medial cruris cartilage. The abnormalities initially appeared when the patient was 7 days old after receiving treatment by nasal continuous positive airway pressure for 7 days. A one-stage procedure was performed as follows: left ala nasi reconstruction with skin excision followed by an ear cartilage graft; a nasal cartilage shield graft to form the nasal tip; reconstruction of the columella with a cartilage graft combined with bilateral soft tissue flaps taken from the nasal floor and mucosa vestibulum; and a full-thickness skin graft to cover the secondary defect resulting from the flaps. At 1-month post-surgery, satisfactory results were reported. Clinical discussion and conclusion Our approach combining two flaps taken from the nasal floor and the inner layer of the ala nasi, a cartilage graft from the ear, and a full-thickness skin graft delivered a one-stage surgical technique that yielded satisfactory results without deformities of the donor site. However, the surgical technique should be individualized to patients. This case report adds to the literature and offers surgeons an alternative approach for managing nasal deformities.

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Nasal columella reconstruction – A comprehensive review of the current techniques

Cited by 16 publications

References 63 publications

Reconstruction of columella and nasal vestibuli by bilateral nasolabial flaps – A case report

Reconstruction of columella and nasal vestibuli by bilateral nasolabial flaps – A case report

Perialar Flap Reconstruction Technique Approach of Nasal Columellar Dehiscence Post Trauma Continuous Positive Airway Pressure (CPAP)

Nasal reconstruction surgery after continuous positive airway pressure delivered by prongs: A case report

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