Jonathan R Abbas1 and Shahram Anari 2
1Blackpool Victoria Hospital, UK 2Heartlands Hospital, UK
Title: Reconstruction of a composite nasal columella defect: A four-step technique
Biography
Biography: Jonathan R Abbas1 and Shahram Anari 2
Abstract
Introduction: Columella reconstruction is a challenging task for surgeons and a number of different techniques have been described in the literature. We report a case where the defect involved columella, caudal septum and the nasal floor. Due to the defect and patient choice, many of the current well-known techniques could not be performed. Materials & Methods: A 70-year-old heavy-smoker female presented with squamous cell carcinoma (SCC) of the columella involving caudal septum and floor of the nose. This was resected using a wide local excision leaving her with a significant defect of the nasal columella, caudal septum and nasal vestibule floor. The reconstructive technique involved 4 distinct operative stages. It is a combination of transposition flaps, pedicle flaps, cartilaginous grafts and skin grafts. Discussion: Many different techniques are available currently. Each has distinct advantages and disadvantages and the anatomy of the defect we wish to reconstruct largely determines the chosen technique. Other factors in technique choice include patients pre-morbid condition, and of course, patient choice. Our technique was reviewed 12 months later and revealed good skin color matching and minimal scarring due to lack of regional flaps. There was slight loss of tip projection however this is minimal. Overall this complied with the patient’s wishes and is a reproducible technique. Conclusion: The nasal columella is a difficult subunit of the nose to reconstruct. There are many factors involved when selecting one of the numerous techniques for reconstruction. Our technique has produced satisfactory results and importantly was compliant with the patient’s wishes.