A modification of the transverse forked flap to allow three-dimensional columella reconstruction

The original transverse forked flap is effective in reconstructing the anterior wall of columella in a single stage without leaving a noticeable secondary deformity. A modification was done to allow reconstruction of the lateral walls of columella in addition. This three-dimensional reconstruction will provide enough coverage for a cartilage graft if used. This modification was applied to three patients with columella defects. A costal cartilage graft was used in one of these patients. All flaps survived and donor site scarring was unnoticeable. Elevation of the base of the forked flap allowed using it to reconstruct the anterior wall of columella while sparing the lateral wings to reconstruct the lateral walls of columella.