(d) A partial- thickness, horizontal relaxing incision
was made medially along the base of the vertical pedicle.
Richter et al4 preferred converting coronal fistulas into coronal hypospadias, followed by tubularisation of the urethral plate with or without a dorsal mid-line relaxing incision
.5 The Thiersch tube repair with or without the relaxing urethral plate incision, as described by Reddy,6 Rich et al7 and Snodgrass,8 had a success rate of 92%.
The surgeon will usually find more mucosa available from the latter source after undermining the floor of the nose laterally as far as the inferior turbinate or even onto the lateral wall of the nose, where an anterior-to-posterior relaxing incision
is made to allow this elevated tissue to be translated medially and onto the septum.
Nine of these required no further treatment, and two had some mild persistence of the cicatrix that was amenable to a simple vertical relaxing incision
of the constricting phimotic ring.
This incision is a relaxing incision
, and it can be extended as far inferiorly as necessary to achieve a tension-free advancement.
A second relaxing incision
may be made at the base of the flap to allow further mobilization; this relaxing incision
may then be skin grafted.