Correction of Nostril Stenosis with W-plasty, Perialar Flap and Foley Expansion Exercise.

Hong, Ki Yong; Lee, Yoon Ho

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(2):143-147.
Published online March 1, 2010.

Correction of Nostril Stenosis with W-plasty, Perialar Flap and Foley Expansion Exercise.

Ki Yong Hong, Yoon Ho Lee

Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea. lyh2374@snu.ac.kr

Abstract

PURPOSE
Nostril stenosis is an uncommon deformity that develops as a consequence of smallpox, chickenpox, tuberculosis, syphilis, congenital malformations etc. There have been several studies on the surgical techniques to treat it. However, it is difficult to maintain the result for a long time. The goal of this study is to evaluate the use of W-plasty, perialar flap as an operative techniques and expansion exercise using Foley catheter as a method to keep the patency of nostril. METHODS: This is a retrospective review of the senior surgeon's(Y.L.) patients who underwent W-plasty and a perialar flap. Patients treated from 2005 to 2009 were reviewed and the postoperative results were evaluated. Average patient age was 24 years, ranged from 1 to 61 years, average follow-up period was 27.5 months, ranged from 3 to 77 months. The mild deformity was released with an incision and expansion by the ballooning of a Foley catheter and corrected by W-plasty only. However, a severe deformity required an additional procedure including perialar flap transposition. During the postoperative period, the patients maintained a nasal stent and exercise using a Foley catheter to prevent recurrence.
RESULTS
Five cases of nostril stenosis in four patients were treated using this technique. One case was corrected with W-plasty only, but four cases were more severe and were corrected with W-plasty and a perialar flap. There were no perioperative complications. The patients were satisfied with the results and retained a good shape during the follow-up periods.
CONCLUSION
Nostril stenosis can be corrected with W-plasty and a perialar flap. A perialar flap is added if W-plasty is unable to correct the deformity. A postoperative nasal stent and expansion with a Foley catheter can help in preventing recurrences.

Keywords: Nostril stenosis; W-plasty; Perialar flap; Foley catheter

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