title: Columella pressure necrosis: a method of surgical reconstruction and its long-term outcome.
abstract: Nasal continuous positive airway pressure (nCPAP) in premature babies may rarely lead to necrosis of the columella. Subsequent functional and cosmetic impairments require surgical corrections to restore nasal anatomy and architecture. The objective of this report is to document the technique of reconstruction in a baby with columella necrosis due to nCPAP treatment. A 21-month-old baby was referred to the oral and maxillofacial unit with a necrotic columella following nCPAP ventilation in a neonatal intensive care unit. Nearly 75% of the vertical columella length was affected. A neocolumella was created using tissues mobilised from the nasal sill region. This report provides a detailed description of a columella reconstruction technique which is valuable to restore aesthetics and function.
authors.affiliation: Department of Oral & Maxillofacial Surgery, Faculty of Dentistry Hong Kong, The University of Hong Kong, Hong Kong SAR.
authors.forename: Yasas Shri Nalaka
authors.initials: YS
authors.lastname: Jayaratne
authors.affiliation: Department of Oral & Maxillofacial Surgery, Faculty of Dentistry Hong Kong, The University of Hong Kong, Hong Kong SAR.
authors.forename: Roger Arthur
authors.initials: RA
authors.lastname: Zwahlen
authors.affiliation: Facial Cleft Deformity Unit, University of Pretoria and Wilgers Hospital, Pretoria, South Africa Department of Oral and Maxillofacial Surgery, College of Oral Health Sciences, University of Technology, Jamaica.
authors.forename: Su Yin
authors.initials: SY
authors.lastname: Htun
authors.affiliation: Facial Cleft Deformity Unit, University of Pretoria and Wilgers Hospital, Pretoria, South Africa.
authors.forename: Kurt-Wilhelm
authors.initials: KW
authors.lastname: Bütow
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009668:Nose Diseases / Q000209:etiology / Q000601:surgery*; D003668:Pressure Ulcer / Q000209:etiology / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D013997:Time Factors
references.citation: Int Wound J. 2014 Jun;11(3):335-6
references.pmid: 23173614
references.citation: Arch Dis Child Fetal Neonatal Ed. 2010 Nov;95(6):F447-51
references.pmid: 20584802
references.citation: J Craniomaxillofac Surg. 2007 Sep-Oct;35(6-7):287-92
references.pmid: 17869531
references.citation: Arch Facial Plast Surg. 2002 Jan-Mar;4(1):42-6
references.pmid: 11843678
references.citation: J Craniomaxillofac Surg. 1989 Nov;17(8):363-6
references.pmid: 2592577
references.citation: Indian Pediatr. 2010 Mar;47(3):265-7
references.pmid: 19430064
references.citation: Arch Dis Child Fetal Neonatal Ed. 2005 Nov;90(6):F480-3
references.pmid: 15941825
references.citation: Arch Dis Child Fetal Neonatal Ed. 1996 Nov;75(3):F209-12
references.pmid: 8976689