Subnasale Flap for Correction of Columellar Deformity

Abstract

The procedure is relatively simple, and primary closure of the donor site is possible without causing external deformity. The subnasale flap can be fashioned without a visible donor-site scar. It is indicated for partial to total reconstruction of columellar defects, aesthetic improvement of narrow columella, and correction of deviated columella.

Subnasale Flap for Correction of Columella Base Deviation in Secondary Unilateral Cleft Lip Nasal Deformity

“…7 However, some patients who present with columella base deviation and secondary UCLN deformity may have been previously misdiagnosed and received inappropriate or inadequately performed surgery. In a case with severe ANS deviation, the cartilaginous portion of the nasal septum and the soft tissue envelope of the columella can be deviated from the facial midline.…”

“…7 (1) From the viewpoint of aesthetics, the SN flap seems superior to other techniques because scar tissue is not as conspicuous from the donor site, and it can be camouflaged with facial cosmetics; (2) because reconstruction takes place in the same visual field as the recipient site, the procedure is technically easier;…”

“…The authors applied the subnasale (SN) flap for the correction of the deviated columella base with various techniques for correction of the secondary UCLN deformity simultaneously. 7 Therefore, the aim of this case report is to present the effects of SN flap on the correction of deviated columella base in the secondary UCLN deformity.…”

Reconstruction of a Columellar Defect With a Nasolabial Island Flap

“…The nasolabial flap [1] is a regional flap that can be easily used to repair the columellar area. Forehead [2] or subnasal [3] flaps can also be used for columellar reconstruction. However, the forehead flap is relatively bulky and donor site morbidity is more commonly associated with this type of flap than with the nasolabial flap.…”

“…Forehead flaps are well suited for reconstructing columellar defects when the defect involves the nasal tip subunit, with or without other adjacent subunits, since the flap will cover these areas as it extends onto the columellar subunit. Subnasal flaps are used for a one-stage procedure that transfers well-match skin to the columella; this technique is relatively simple and donor site morbidity is rarely observed [3]. However, the flap should be an adequate size since too much length predisposes the flap to necrosis and occasionally hair growth can develop in this area [3].…”