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CASE REPORT
Columella pressure necrosis: a method of surgical reconstruction and its long-term outcome
  1. Yasas Shri Nalaka Jayaratne1,
  2. Roger Arthur Zwahlen1,
  3. Su Yin Htun2,3,
  4. Kurt-Wilhelm Bütow2
  1. 1Department of Oral & Maxillofacial Surgery, Faculty of Dentistry Hong Kong, The University of Hong Kong, Hong Kong SAR
  2. 2Facial Cleft Deformity Unit, University of Pretoria and Wilgers Hospital, Pretoria, South Africa
  3. 3Department of Oral and Maxillofacial Surgery, College of Oral Health Sciences, University of Technology, Jamaica
  1. Correspondence to Professor Roger Arthur Zwahlen, zwahlen{at}hku.hk

Summary

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.

https://doi.org/10.1136/bcr-2013-203132

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