28 Reconstruction of Tissue Loss: Columella and Nasal Tip
Nasal cannulas are often used for oxygen administration in premature infants. Prolonged cannula pressure on the delicate nasal tissues of a newborn baby may cause injuries ranging from pressure sores to necrosis and superinfection. The following case involves a young woman who had two previous reconstructive operations for columellar necrosis. 1
Case 43
Introduction
This 20-year-old woman had undergone two previous operations. As a premature baby, this patient had a nasal tube for several weeks. During nasal intubation, necrosis of the columella occurred. During the first operation, simple stitches were placed to adapt the wound margins without reconstruction of the columella tissue defect. The second procedure was a VY plasty of the columella.
Findings
Frontal view ( Fig. 28.2a ) shows an amorphous nasal tip with poorly defined alar contours. Basal view ( Fig. 28.2b ) shows a scarred columella with a wide base. Profile view ( Fig. 28.2c ) shows unnatural cephalic rotation and shortening of the nose.
Fig. 28.2d , Fig. 28.2e , and Fig. 28.2f show corresponding views 4 years after revision rhinoplasty.
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