A New Two-Staged Method for Total Columellar Reconstruction.

Area of Science:

• Plastic Surgery
• Otolaryngology
• Facial Reconstruction

Background:

• The nasal columella presents significant reconstructive challenges due to its delicate anatomy and central facial location.
• Full-thickness columellar defects are particularly difficult to manage, with limited options from adjacent local flaps due to vascular supply and bulk.
• Forehead flaps are commonly used for nasal reconstruction but can be hindered by a low hairline, complicating columellar defect repair.

Purpose of the Study:

• To present a novel two-staged forehead flap technique for total nasal columellar reconstruction.
• To address the specific challenges of columellar reconstruction in pediatric patients with low hairlines.
• To offer an alternative method that avoids the transfer of hair-bearing skin to the reconstructed columella.

Main Methods:

• A two-staged forehead flap procedure was designed and implemented for total columellar reconstruction.
• The technique was applied to a 9-year-old child with a full-thickness columellar defect.
• Consideration was given to patients with low hairlines to prevent aesthetic compromise.

Main Results:

• The described two-staged forehead flap technique successfully reconstructed the total columellar defect.
• The method proved particularly useful for patients with a low hairline, avoiding undesirable hair-bearing skin transfer.
• The approach offers a reliable solution for challenging columellar reconstructions.

Conclusions:

• A two-staged forehead flap is an effective method for total nasal columellar reconstruction.
• This technique is especially beneficial for pediatric patients with low hairlines, ensuring aesthetic outcomes.
• The presented approach expands reconstructive options for difficult columellar defects.