Scalp Composite Tissue Transplantation for the Reconstruction of Nasal Columella Defects: A Clinical Study

The repair of defects in the nasal columella has consistently posed a significant clinical challenge. This study aims to examine the feasibility and effectiveness of scalp composite tissue transplantation for the reconstruction of nasal columella defects.

This case series study encompasses patients who underwent reconstruction of nasal columella defects utilizing the scalp composite tissue transplantation technique between June 2018 and January 2024. The scalp composite tissue was harvested from the area located behind the ear. The composite tissue includes subcutaneous adipose layers. Hyperplastic scar tissue was excised, and appropriate cavities were created to define an optimal soft-tissue region for reconstruction. Subsequently, the composite tissue was meticulously sutured to the recipient site.

This study included 45 patients. All patients underwent successful surgical intervention without any intraoperative complications. Five patients experienced partial necrosis of the composite tissue; however, the wounds healed satisfactorily after 2 weeks of dressing changes. The transplanted composite tissues in the other patients demonstrated favorable survival rates. In 2 patients, after a single transplantation procedure, improvements in columella defects were observed; however, insufficient tissue volume remained. As a result, these patients underwent a second scalp composite tissue transplantation 6 months postoperatively. Most patients (41 out of 45; 91.1%) expressed satisfaction with the surgical reconstruction outcomes.

Our findings indicate that scalp composite tissue grafts are a viable approach for reconstructing nasal columella defects.

Level IV, therapeutic study.