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Case Reports
. 2014 Aug 5:2014:bcr2013203132.
doi: 10.1136/bcr-2013-203132.

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

Yasas Shri Nalaka Jayaratne  1 , Roger Arthur Zwahlen  1 , Su Yin Htun  2 , Kurt-Wilhelm Bütow  3
Affiliations
Case Reports

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

Yasas Shri Nalaka Jayaratne et al. BMJ Case Rep. .

Abstract

Nasal continuous positive airway pressure (nCPAP) in premature babies may rarely lead to necrosis of the columella. Subsequent functional and cosmetic impairments require surgical corrections to restore nasal anatomy and architecture. The objective of this report is to document the technique of reconstruction in a baby with columella necrosis due to nCPAP treatment. A 21-month-old baby was referred to the oral and maxillofacial unit with a necrotic columella following nCPAP ventilation in a neonatal intensive care unit. Nearly 75% of the vertical columella length was affected. A neocolumella was created using tissues mobilised from the nasal sill region. This report provides a detailed description of a columella reconstruction technique which is valuable to restore aesthetics and function.

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Figures

Figure 1
Figure 1
The appearance of the columella defect at the time of surgery.
Figure 2
Figure 2
A diagram highlighting the two main incisions (fat dashed lines).
Figure 3
Figure 3
The first incision along the nasolabial fold.
Figure 4
Figure 4
Mobilisation of the neocolumella under gentle, steady upward pull.
Figure 5
Figure 5
The final results after columella reconstruction.
Figure 6
Figure 6
A 5-year postoperative control, oblique and lateral views.
See this image and copyright information in PMC

References

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