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

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.

Congenital Constriction Band of the Trunk

Congenital constriction band of the trunk is a rare congenital malformation. A 14-year-old girl with a congenital circumferential constriction band around the waist is described. Seven other cases of congenital constriction band on the trunk are reviewed in the literature. This malformation is probably related to the amniotic band syndrome such as constriction band on the limbs. The surgical treatment of this constriction band was W-plasty and produced good cosmetic results.