Columella Reconstruction Using the Philtral Flap in Patients with Columellar Deformity in Revision Rhinoplasty

Columellar defects, resulting from trauma or surgery, pose both functional and aesthetic challenges. This study evaluates the functional and aesthetic outcomes of columellar reconstruction using the philtral flap method in a case series of fourteen patients with columellar defects, focusing on respiratory and aesthetic outcomes.

Participants: Fourteen patients with columellar defects.

Costal cartilage was harvested, and a philtral flap was designed with an open approach. Septal and nasal floor mucosae were elevated bilaterally, and a vertical incision was made on the philtrum. A full-thickness flap, including orbicularis oris muscle, was mobilized, and the nasal framework reconstructed with rib cartilage.

The SCHNOS questionnaire assessed functional outcomes, while photographic analysis evaluated aesthetic changes. Data were analyzed using SPSS version 24.

Functional Outcome: Significant improvement in the respiratory index (p <  .001). Aesthetic Outcome: Significant improvement in the nasal aesthetic index (p < 0.001). Photographic Analysis: Significant changes in philtral and columellar lengths, show, and Goode's ratio.

The philtral flap method provides promising functional and aesthetic outcomes, with further studies needed to confirm these findings.

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