Half nose

The surgical repair of half-nose

Absence of half-nose is an extremely rare congenital malformation, which has a devastating impact on the patient and the family. A review of indexed English-language literature found 91 cases of half-nose, including 50 patients with proboscis lateralis. Pathogenesis is not clear, and the reported cases have sporadically occurred. Many aspects must be considered when reconstructing a congenital half-nose, such as timing of surgery, type of tissue to be used and the need to reconstruct nasal airway. The aim of this article is to present personal experience in seven cases of half-nose reconstruction, in order to review the literature regarding to this rare entity, highlighting aspects of incidence, pathogenesis and surgical treatment. Nasal reconstruction was performed at ages of 5-7 years to minimise psychological trauma. Forehead skin demonstrated to be an excellent donor site to re-surface the nose. For the inner lining, contralateral cutaneous nasal flap was our preference. Concerning the nasal framework reconstruction, alar contour was restored using a cartilage graft from the lower portion of ear tragus and concha.

Simultaneous and symmetrical reconstruction of heminose and restoration of nasal airway in congenital absence of heminose

Congenital absence of heminose is an extremely rare anomaly. Reconstruction of full thickness defects of the nose requires lining, support and cover. Reconstruction of congenital absence of heminose has an additional requirement of reconstruction of the nasal airway. Simultaneous reconstruction of the heminose and internal nasal passage has not been reported earlier. In a case of congenital absence of heminose, reconstruction of the heminose and internal nasal passage was done simultaneously by using expanded forehead tissue and a nasolabial flap. The nasolabial flap is robust and supports the alar margin without any need of cartilage support. The bulk of subcutaneous tissue it carries lies on the outerside of nostril and, therefore, it does not obstruct the nasal opening. This was covered by expanded forehead tissue, which got thinned out due to tissue expansion, thus achieving symmetry with other half of nose. Skin of the nasolabial flap lines nasal passage thereby avoiding the need of splintage of nasal airway which is required if nostril is lined by split skin graft.

Proboscis lateralis of nose

A rare case of congenital malformation of the nose that was successfully corrected surgically is reported.

Half nose with ipsilateral eye and ear anomalies and facial asymmetry: report of a case with cephalometric analysis and orthodontic treatment

OBJECTIVE

Unilateral nostril agenesis together with ipsilateral alterations of the eye, ear, and face make up a spectrum of anomalies. The aim of this study is to report a case in a Japanese girl, 14 years, 5 months of age. Cephalometric analysis is provided, and orthodontic treatment is discussed.

DESIGN

Lateral and frontal cephalograms were compared to a Japanese control group. Outcome of the orthodontic treatment was evaluated by comparing cephalograms taken before and after orthodontic treatment.

RESULTS

The lateral cephalometric analysis showed a severely hypoplastic maxilla in both sagittal and vertical dimensions, coupled with a decreased posterior cranial base. The mandibular rami were asymmetric. The frontal cephalogram showed decreased cranial width and maxillary alveolar width, together with an increased interorbital distance.

CONCLUSIONS

Serial lateral cephalograms during the orthodontic treatment from the age of 14 to 20 years demonstrated no significant maxillary growth and some mandibular growth, coupled with labial tipping of the maxillary central incisors.

Half nose

A very rare abnormality is reported of congenital absence of the right half of the nose in combination with microphthalmia, coloboma, epiphora and median cleft of the alveolus.