OBJECTIVE: To introduce the clinical application of long slender tubed flap constructed with "bridge" technique in the repair of nasal columella defect. METHODS: From March 1968 to August 1998, 18 cases with complicated nasal columella defects were repaired with long slender tubed flaps. Among the 18 tubed flaps, 13 cases were designed on the medial side of the upper arm and 5 cases on the longer cervical region paralleling the clavicle. The tubed flaps were 2.0 to 2.5 cm wide and 11 to 15 cm long. The length of the "bridge" was 3 to 7 cm. RESULTS: No flap necrosis or other complications occurred. Postoperative follow-up was 3 to 60 months. The reconstructed columellae showed satisfactory contour, good texture and color, and satisfactory resistance to injury. CONCLUSION: By using the "bridge" technique, tubed flap can be made long and slender enough to provide relatively abundant tissue with adequate circulation and delicate contour. Combined with strict case selection, long slender tubed flaps can bring excellent functional and cosmetic outcomes in the repair of nasal columella defects including those with partial defect of the nasal tip, ala, septum, or defect of adjacent soft tissue. However, this method is relatively time-consuming.
