Reconstruction of columella and nasal vestibuli by bilateral nasolabial flaps – A case report. (January 2022)

• Record Type: Journal Article
• Authors: Krogerus, Christina; Demant, Mia; Lindskow, Thomas; Hesselfeldt, Jørgen
• Is Part Of: International journal of surgery case reports. Volume 90(2022)
• Publication Date: 2022-01
• Subjects: Nasal reconstruction -- Nasolabial flap -- columella reconstruction -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.106694
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction and importance: The nose is a common location for non-melanoma skin cancers. Resection of such cancers can result in large, multilayer defects that are challenging to reconstruct. The surgical approach is determined by multiple factors and the main goal is to obtain a satisfactory functional and aesthetic result. We present a case of reconstruction of the nasal vestibuli and columella by two transnasal nasolabial flaps. Presentation of case: A 66-year-old male underwent resection of a large squamous cell carcinoma in the right nasal vestibulum that extended through the columella into the left vestibulum. The resection resulted in a multilayer defect including the floor and roof of the right vestibulum, the entire columella, part of the septum cartilage and floor of the left vestibulum. The defect was reconstructed in two stages by bilateral nasolabial flaps, that were brought into the nasal cavity through incisions on the side of the nose and were used to line the vestibuli and sutured to each other medially to form the neocolumella. No complications or surgical site infections were observed. Clinical discussion: Transnasal nasolabial flaps can be used for larger columellar defects. The length of the flaps in our case provided enough tissue to reconstruct the columella as well as the entire vestibular linings. Conclusion: We describe a successful reconstruction of the nasal vestibuli and columella with two transnasal nasolabial flaps, which provided an acceptable aesthetic and functional result. Highlights: The columella is one of the most challenging nasal subunits to reconstruct Nasolabial flaps are useful in columellar reconstruction. A transnasal approach provides the flap with useful extra length An acceptable functional and aesthetic result was obtained using bilateral transnasal nasolabial flaps