Columellar reconstruction with chondrocutaneous graft after injury caused by CPAP

Autor: Giovanna Calil Vicente Franco de Souza, Claudio Messias Moraes, Marcos Antônio Teixeira do Amaral Filho, Sara Ferreira Faro, Daniel de Cazeto Lopes, Ricardo Portella Perrone
Jazyk: English<br />Portuguese
Rok vydání: 2020
Předmět:
Zdroj: Revista Brasileira de Cirurgia Plástica, Vol 35, Iss 03, Pp 363-367 (2020)
Druh dokumentu: article
ISSN: 1983-5175
2177-1235
DOI: 10.5935/2177-1235.2020RBCP0063
Popis: Introduction: Continuous positive pressure in the nasal airways (CPAP) is a non-invasive form of ventilation used in premature newborns in intensive care units. However, it can affect the nose of these patients, even evolving with ischemia and columellar necrosis. Several techniques are described to reconstruct the columella, such as skin grafts, composite grafts, local flaps, and free flaps, but the atrial chondrocutaneous graft has stood out. This study aims to describe a case of columella necrosis using CPAP with reconstruction using posterior atrial chondrocutaneous grafting. Case Report: A brown, female patient, with a history of prematurity and prolonged use of CPAP when she was born due to hyaline membrane syndrome, developed columella necrosis. The patient underwent posterior auricular chondrocutaneous grafting to reconstruct the columella. She presented a satisfactory surgical result, evolving with 100% graft vitality. Discussion: Columellar necrosis associated with the use of CPAP can be aesthetically and functionally debilitating, and represents a reconstructive challenge. The options for obtaining acceptable results are limited. However, the use of ear grafts is technically straightforward, uses structurally similar donor tissues, does not cause additional scarring on the nose, is performed in a surgical period, and generally has an excellent result. Posterior auricular composite grafting for columellar reconstruction proved safe, with satisfactory aesthetic and functional results and minimal morbidity in the donor area.
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