Perialar Flap Reconstruction Technique Approach of Nasal Columellar Dehiscence Post Trauma Continuous Positive Airway Pressure (CPAP)

Main Article Content

Abdul Qadar Punagi
Nurul Haerani Sukindar
Masyita Dewi Ruray

Keywords

CPAP, Defect, Columella, Perialar Flap

Abstract

Introduction: Continuous positive airway pressure (CPAP) is often used in neonates with respiratory distress. However, long-term use of CPAP can cause columella necrosis. This mechanism results from a pressure injury or shear force when the device is applied to the nose. Techniques of columella reconstruction has its indications, advantages and disadvantages.
Case: A 9-year-old girl came with anterior nasal aseptum. The patient was born prematurely with a gestational age of 6 months. The patient then received ICU Treatment for Respiratory Distress Syndrome due to prematurity with CPAP for 3 months. The patient finished therapy but came home with a columella defect. On the Multi Slice CT-Scan examination, soft tissue defect columella were
seen. The patient then underwent columella reconstruction surgery with the dextra et sinistra perilar flap technique.
Conclusion: Long-term use of CPAP increases the risk of columella injury. There is a need for both a preventive approach to the CPAP adhesion site in the nose to prevent further nasal injury and appropriate management of this injury. Columella reconstruction technique in the form of perialar flap technique in patients has satisfactory results.

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References

1. Gupta, S., & Donn, S. M. 2016. Continuous positive airway pressure: physiology and comparison of devices. In Seminars in Fetal and
Neonatal Medicine (Vol. 21, No. 3, pp. 204-211). WB Saunders.
2. Delmore, B., Deppisch, M., Sylvia, C., LunaAnderson, C., & Nie, A. M. 2019. Pressure injuries in the pediatric population: a national
pressure ulcer advisory panel white paper. Advances in Skin & Wound Care, 32(9), 394-408.
3. Nowicki J, Abbas J. R, Sudbury D, Anari S. 2020. Nasal columella reconstruction - A comprehensive review of the current techniques.
J Plast Reconstr Aesthet Surg. 2020;73(5):815-827. doi:10.1016/J.BJPS.2020.01.016
4. Chao, J. W., Raveendran, J. A., Sauerhammer, T. M., Rogers, G. F., Oh, A. K., & Boyajian, M. 2017. Columellar reconstruction after nasal
continuous positive airway pressure associated necrosis. Journal of Craniofacial Surgery, 28(4), 928-930.
5. Odobescu, A., Servant, J. M., Danino, I. W., & Danino, M. A. 2011. Nostril alar rim threshold flap for columellar reconstruction. Journal of
plastic, reconstructive & aesthetic surgery, 64(7), 929-933.