Pediatric Nasal Tip Amputation Successfully Treated with Nonmicrovascular Replantation and Hyperbaric Oxygen Therapy

Jason D Pou; H Devon Graham

Pediatric Nasal Tip Amputation Successfully Treated with Nonmicrovascular Replantation and Hyperbaric Oxygen Therapy

Ochsner J. 2017 Summer;17(2):204-207.

Authors

Jason D Pou¹, H Devon Graham^{1

2

3}

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.
² Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, LA.
³ The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.

PMID: 28638297
PMCID: PMC5472083

Abstract

Background: Nasal tip amputation is a rare but difficult problem to manage. Nonmicrovascular nasal tip replantation is a valid and relatively simple repair option for moderate nasal defects, but tissue ischemia and graft failure occur frequently.

Case report: We present the case of a pediatric nasal tip amputation from a dog bite treated with replantation within 5 hours. The 2.5-cm avulsed tip contained skin, cartilage, and mucosa and was replanted as a 3-layer composite graft. Hyperbaric oxygen (HBO) therapy was initiated for 2 weeks postoperatively. The outcome was functionally adequate, and the majority of the native nasal tissue was salvaged.

Conclusion: HBO therapy can be used after nonmicrovascular nasal tip replantation to improve graft survival and potentially decrease the need for revision surgery.

Keywords: Amputation–traumatic; hyperbaric oxygenation; nasal surgical procedures; nose deformities–acquired; otorhinolaryngologic surgical procedures; replantation.

Publication types

Case Reports