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

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.