Reconstruction of the Nasal Columella

Abstract

To report techniques successful for nasal columella reconstruction.Methods: Retrospective medical chart review of patients undergoing columella reconstruction by 2 of us (D.A.S. and P.A.H.) from January 1, 1982, to December 31, 2000. Photographs before tumor resection or trauma, after resection or trauma, and after reconstruction were examined by facial plastic surgeons masked to the cases and were rated on a 10-cm visual analogue scale.Result: Sixteen patients were identified, most of whom had columellar defects repaired with forehead flaps, nasolabial flaps, or nasofacial sulcus flaps. The mean improvement on the 10-cm visual analogue scale was 2.0 from before tumor resection or trauma to after reconstruction, and 5.0 from tumor resection or trauma to after reconstruction. Conclusion:Skin grafts, composite grafts, and several flaps, including nasolabial, nasofacial sulcus, and forehead flaps, are useful in repairing defects of the nasal columella.

Columella pressure necrosis: a method of surgical reconstruction and its long-term outcome

“…Columella reconstruction is a challenge due to the lack of skin and underlining tissue, its unique contour and scarce vascularity 6. In addition, to gain enough tissue, usually the width of the nasal sill has to be compromised.…”

Nasal trauma: Primary reconstruction with open rhinoplasty

“…Columella is a tricky subunit to repair because of the low availability of neighbouring skin (17); in a study by Sherris et al (17), only one of 16 patients with columella defect due to trauma was operated with the use of a local flap. In complex wounds, the aesthetic result should be judged at a later time.…”

“…In complex wounds, the aesthetic result should be judged at a later time. In cases of unsatisfactory wound healing, a second skin flap or free graft reconstruction can be performed (7,17).…”

Nasal reconstruction: the state of the art

“…Even small defects of the columella may occasionally require a composite graft from the auricle. For most larger columellar defects, either forehead or superior based, two-staged melolabial flaps represent the closure of choice [32]. When columellar defects are associated with cleft lip deformity, as is frequently the case, composite grafts from the helix provide excellent results [29].…”