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A Simple Protective Splint for Infant Nasal Reconstruction.

William J Rifkin1, Sandra Maroutsis, Sabrina A Bohsali

  • 1William J. Rifkin, MD, is a plastic surgery resident in the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY. Sandra Maroutsis, RDH, is a dental hygienist at Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY. Sabrina A. Bohsali, CDA, is a dental assistant at Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY. Roberto L. Flores, MD, is Joseph G. McCarthy Associate Professor of Reconstructive Plastic Surgery and Director of Cleft Lip & Palate, Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health. New York, NY.

Plastic Surgical Nursing : Official Journal of the American Society of Plastic and Reconstructive Surgical Nurses
|May 29, 2019
PubMed
Summary

Nasal continuous positive airway pressure (NCPAP) can cause columellar necrosis. This study presents a novel nasal splint enabling early surgical repair in infants, overcoming challenges of delayed intervention.

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Area of Science:

  • Plastic Surgery
  • Pediatric Otolaryngology
  • Craniofacial Surgery

Background:

  • Nasal continuous positive airway pressure (NCPAP) is crucial for infant respiratory support but can lead to nasal trauma.
  • Columellar necrosis, a rare but severe complication of NCPAP, presents significant reconstructive challenges in infants.

Observation:

  • A case of composite nasal reconstruction in an infant with columellar necrosis secondary to NCPAP is detailed.
  • The study highlights difficulties in surgical repair, including contour matching, vascularity, and skin availability.

Findings:

  • A simple, inexpensive, and protective nasal splint was designed and implemented.
  • This splint facilitates early surgical repair in infancy, addressing concerns about postoperative graft protection.

Implications:

  • Early surgical intervention for columellar necrosis in infants is now feasible with the novel splint.
  • The technique offers a promising solution for improving outcomes in infants experiencing NCPAP-related nasal complications.
  • This approach may reduce the need for delayed, more complex reconstructions later in childhood.