Congenital Aplasia of Lower Lateral Cartilage, the Reconstruction via Closed (Endonasal) Rhinoplasty Approach

Al-Obiedi Salim Hussain Ibrahim

doi:10.23937/2572-4193.1510112

Abstract

Congenital nasal anomalies are rare. Hypoplasia and atrophic anomalies represent the most common class of congenital nasal anomalies. A 27-year-old female presented with obvious right nostril asymmetry, alar notching, and retraction. The patient underwent a closed (endonasal) septorhinoplasty approach under general anesthesia. The lower lateral cartilage exposed by the cartilage delivery technique was discovered the absence of right lower lateral cartilage. In this case, reconstruction was performed by using two grafts the resected cephalic portion of lateral crura of left lower cartilage as medial crus and harvested septal cartilage as lateral crus, with satisfactory functional and cosmetic results.

Highlights

The congenital anomalies of the nose are rare [1], occur in 1\20000-1\40000 of newborns [2]
The harvested septal cartilage graft (24 mm length, 8 mm-3 mm wide) was fixed medially to the dome by 6/0 PDS and laterally insert the cartilage in the dissected tunnel at the alar margin extending to the alar base as lateral crura (Figure 2E and Figure 2F)
The atrophy or weakness of lateral crura causes alar rim notching with retraction and lateral nasal wall weakness and the underdeveloped medial crura present with under projected tip and lack of tip definition [10] and external nasal valve dysfunction [11]

Summary

Introduction

The congenital anomalies of the nose are rare [1], occur in 1\20000-1\40000 of newborns [2]. The anomalies of the nose range from complete aplasia of the nose to duplications and nasal masses [3]. The incidence of Lower lateral cartilage aplasia was reported about 0.016 of consecutive series of primary septorhinoplasty patients [8]. The lateral processes develop into the nasal bones, upper lateral cartilages, ala, and lateral crura of the lower lateral cartilages [5]. The harvested septal cartilage graft (24 mm length, 8 mm-3 mm wide) was fixed medially to the dome by 6/0 PDS and laterally insert the cartilage in the dissected tunnel at the alar margin extending to the alar base as lateral crura (Figure 2E and Figure 2F). A satisfactory functional and cosmetic result was achieved (Figure 1)

Discussion

Conclusions