title: Construction of the congenitally missing columella in midline clefts.
abstract: BACKGROUND
  Repair of the rare median cleft lip occurring with agenesis of the columella is a challenge as there is a major deficiency of skin and underlying structures.
  
  
  METHODS
  Over a 23- year period, five children underwent construction of a columella. A new surgical technique was designed for this: an internal dorsal nasal flap was used to create a cutaneous-cartilaginous flap inside the nasal dome, and was then sutured inferiorly against a superior triangle of the repaired median cleft lip.
  
  
  RESULTS
  Projective nasal growth could be seen in three of the five surgically constructed columellae in whom the medium-term results could be evaluated.
  
  
  CONCLUSIONS
  Five holoprosencephaly cases, all with a median cleft lip and agenesis of the columella, underwent a median cleft lip repair and the creation of a columella by means of an internal nasal dorsal skin flap procedure.
authors.affiliation: Department of Maxillo-Facial and Oral Surgery, University of Pretoria, Pretoria, South Africa. kwbutow@medic.up.ac.za
authors.forename: Kurt-Wilhelm
authors.initials: KW
authors.lastname: Bütow
mesh_terms: D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D016142:Holoprosencephaly / Q000601:surgery; D006801:Humans; D009300:Nasal Septum / Q000002:abnormalities* / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D012225:Rhinoplasty / Q000379:methods*; D016038:Skin Transplantation; D013524:Surgical Flaps