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"An innovative method for nasal injury repair after use of CPAP in newborns".

179e texture of the graft and risk of composite graft loss are reported complications of this technique. The bilateral reverse-U technique described by Tajima and Maruyama5 has been described before only for bilateral primary cleft lip nose repair. This article describes a personal surgical technique for nasal repair in patients with columellar necrosis caused by nasal continuous positive airway pressure treatment. The columella is repaired using tissues from the tip of the nose. This method is based on bilateral invertedU incisions described by Tajima and currently used for primary bilateral cleft lip nose repair. The patient is operated on under general anesthesia. Initially, the scar tissue from the nasal septum and remaining borders of the columella is trimmed. Then, bilateral inverted-U nasal and marginal incisions are performed and finally connected, as in Figure 1. The distance from the top of the incision to the nostril rim should be the same as the length of the columellar defect (approximately 4 mm). The area of skin between these incisions (soft triangle area) is resected, as in Figure 1. The nasal flap is dissected using fine scissors at the level of the cartilages of the nose and elevated like an of the ladder in the closure of palatine fistula in cleft patients. Although it needs expertise in microvascular reconstruction, in cleft palate surgery, it is a safe procedure with low donor-site morbidity.