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07 April 2024 : Case report  Italy

[In Press] Columella Reconstruction Using a Bilateral Nasolabial Flap: A Case Report

Unusual setting of medical care, Rare disease

Fabio Bertone1AEF, Giovanni Di Cintio1ABE, Simone Moglio2E, Alice Azizi Semeskandi2E, Gianluca Averono1E, Carmine Fernando Gervasio12A

DOI: 10.12659/AJCR.943913

Am J Case Rep In Press; DOI: 10.12659/AJCR.943913  

Available online: 2024-04-07, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


The columella has many fundamental functions, such as nasal breathing and support of the nasal tip, in addition to the aesthetic role it plays. The columella is one of the most difficult nasal subunits, both from the point of view of disease control and from that of reconstruction. Lesions involving the columella can be difficult to control, and malignancies can spread to the septum, subcutaneous tissues of the lip, and floor of the nasal cavities. Many columella reconstruction methods after resection have been proposed (local nasal flaps, skin grafts, regional flaps, free flaps), depending on the size of the defect, patient’s features, surgeon’s experience, and patient’s aesthetic wishes.
We present a case of an 82-year-old woman with various comorbidities who had squamous cell carcinoma (G2) originating from the skin of the right side of the columella. The lesion infiltrated the cartilage, arriving to the skin of the columella on the left side and extending to the mucosa of the nasal septum bilaterally. Reconstruction was conducted using a bilateral nasolabial flap, with good functional and aesthetic result. Surgical revision for the autonomization of pedicled flaps was not necessary, nor desired by the patient.
The bilateral nasolabial flap is an effective and safe solution for reconstructing the columella, with good support of the tip even without cartilaginous graft. This technique is especially feasible in elderly patients and those with concomitant pathologies, who benefit from rapid healing of the wound.

Keywords: Nose Neoplasms; Surgical Flaps

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923