Modification of running Y-V plasty to correct bilateral nostril stenosis with a circular, linear contracture.

Abstract

Acquired nostril stenosis usually develops from scar contracture due to trauma or infection. The purpose of surgical repair is to emulate the lobule-columella-ala complex, anatomically reconstruct adequate nostrils and maintain long-term patency. A linear scar contracture may be released by a Y-to-V advancement technique, as part of a running Y-V plasty procedure. Nostril stenosis with a circular, linear contracture involving the columella, ala and nostril sill is difficult to correct satisfactorily by W-plasty or Z-plasty alone. We used running Y-V plasty with six triangular flaps of the Y on each external and internal surface in two cases of bilateral nostril stenosis after smallpox, a method that provides one largest external flap for the nostril sill, two external flaps for the ala and the columella each and one external flap for the soft triangle. This technique was easily designed and achieved adequate release and coverage without the use of additional local flaps, and yielded reconstructed nostrils of sufficient size. The running Y-V plasty technique is feasible for correction of nostril stenosis with linear contracture involving the entire nostril rim.