Surgical reconstruction of the columella after necrosis caused by an infantile hemangioma.

Abstract

Background: Infantile hemangiomas are common vascular tumors in childhood that usually undergo spontaneous involution. However, complications may arise, particularly in visible areas such as the centrofacial region, leading to significant aesthetic and functional sequelae. Columellar necrosis is a rare but challenging complication requiring specialized reconstruction techniques.

Methods: This report presents two cases of columellar necrosis caused by infantile hemangiomas. Reconstruction was achieved using a 3-component technique: cartilage grafts for tip support, oral vestibule mucosal flaps for lateral lining, and cutaneous turn out flaps from the columellar stumps for anterior skin coverage.

Results: Both patients achieved excellent functional and aesthetic outcomes. The described technique allowed for reliable reconstruction of the columella, addressing both structural integrity and cosmetic appearance.

Conclusion: Reconstruction of columellar defects, particularly in pediatric cases, is challenging due to the columella's small size and challenging anatomy. The described 3-component technique offers a reproducible and effective approach for isolated columellar defects, ensuring satisfactory functional and aesthetic results.