Columellar Reconstruction After Nasal Continuous Positive Airway Pressure Associated Necrosis
| Autor: | Albert K. Oh, Jerry W. Chao, Michael K. Boyajian, Gary F. Rogers, Janani A. Raveendran, Tina M. Sauerhammer |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Reconstructive surgery Esthetics medicine.medical_treatment Ischemia Surgical Flaps Necrosis 03 medical and health sciences 0302 clinical medicine Notching Intensive care Pressure medicine Humans Continuous positive airway pressure 030223 otorhinolaryngology Nasal Septum Retrospective Studies Columella Continuous Positive Airway Pressure business.industry Infant Soft tissue General Medicine Airway obstruction Rhinoplasty medicine.disease Surgery Otorhinolaryngology Child Preschool business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Craniofacial Surgery. 28:928-930 |
| ISSN: | 1049-2275 |
| DOI: | 10.1097/scs.0000000000003296 |
| Popis: | Though a life-saving modality in neonatal intensive care units, nasal continuous positive airway pressure (nCPAP) carries a small risk of irreversible ischemia and necrosis of the columella due to the configuration of the pressure delivery system. Iatrogenic injuries to the columella after nCPAP use result in a spectrum of disfigurement and functional airway obstruction. The authors performed a retrospective review of patients evaluated for nCPAP-related columellar deformities by the Division of Plastic and Reconstructive Surgery at the authors' institution over a 10-year period to assess reconstructive outcomes. Of 7 patients evaluated, 3 underwent reconstruction using a combination of cartilaginous framework reshaping and local tissue flaps. After a mean follow-up period of 78 months, patients had satisfactory aesthetic and functional results. Based on the authors' observations, columellar necrosis secondary to nCPAP can be divided into 3 categories: Type A demonstrates mild notching of the columella; Type B has an absent columella without notable nasal tip depression; Type C has an absent columella with nasal tip depression, with or without external nasal valve obstruction. Reconstructive needs should be individually tailored based on the degree of nasal tip depression, cartilaginous support, and soft tissue availability. |
| Databáze: | OpenAIRE |
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