Total Nose Research Articles

Prelaminated Nose Reconstruction: Comparison of Forehead and Radial Donor Site and Review of the Literature.

Total nose reconstruction is demanding as it is a 3-dimensional structure that needs lining, support and external coverage. Usually, several stages are needed to achieve a satisfactory result. The authors present 2 cases of prelaminated radial forearm and 2 prelaminated forehead nose reconstructions and compare both methods. According to our review of the literature, this is the first report of prelaminated forehead for total nose reconstruction. The last 5 years the authors have treated 4 patients with prelaminated flaps for total nose reconstruction. The age ranged from 50 to 75 years. There were 3 male patients and one female. Three patients underwent total nose amputation due to squamous cell carcinoma and one due to melanoma. Two patients were treated with prelaminated radial forearm reconstruction and 2 with prelaminated forehead reconstruction. Both patients that were treated with prelaminated radial forearm reconstruction had the collapse of the nasal pyramid and had salvage procedures with replacement of the cartilaginous framework with iliac bone graft framework. Prelaminated nose reconstruction with either the radial forearm or forehead flap needs several stages. There is the possibility of infection-collapse of the cartilage framework, therefore, the authors recommend reconstruction of the nasal skeleton with an iliac bone graft. The flaps are stiff and difficult to handle. The authors don't think that prelaminated nose reconstruction with the radial forearm flap has advantage compared with the classic several stages nose reconstruction with radial forearm flap. Possibly, prelaminated forehead reconstruction can be applied for aged patients who cannot undergo microsurgical reconstruction.

Long-term effects of the titanium butterfly implant on quality of life: a prospective cohort study

PurposeNasal valve insufficiency is known to have a negative impact on both nasal patency and quality of life. The titanium butterfly implant is a surgical treatment proven to have a positive effect on these aspects up to 6 months postoperative. This study aimed to determine the long-term effects of the titanium butterfly implant on nasal obstruction symptoms and quality of life in adult patients with nasal valve insufficiency up to 5 years after procedure.MethodsA prospective single cohort study was performed including 29 patients that underwent the titanium butterfly implant in one tertiary medical center. Data was obtained before and at least 5 years after surgery using three questionnaires: the Nasal Obstruction and Septoplasty Effectiveness questionnaire, the Sino-Nasal Outcome Test 22 and the Glasgow Benefit Inventory questionnaire.ResultsA significant decrease in total NOSE score was seen compared to baseline measurements. The SNOT-22 scores also showed a significant decrease, whereas the GBI scores showed no significant changes at the late follow-up.ConclusionSeven years after placement the titanium butterfly implant still has a statistically significant improvement on otorhinologic-related quality of life compared to preoperative measurements.

Effects of probiotics on the prevention and treatment of children with allergic rhinitis: a meta-analysis of randomized controlled trials.

Recent studies have demonstrated the anti-allergic effects of probiotics in humans. However, their role in preventing and treating pediatric allergic rhinitis has not been thoroughly investigated. This study aimed to systematically review the efficacy and preventive effects of probiotics on pediatric allergic rhinitis. We systematically searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science databases for all relevant studies on probiotics and pediatric allergic rhinitis. Studies meeting the inclusion criteria were included, data were extracted, and meta-analyses were performed. A total of 28 studies with 4,765 participants were included in this study. The pooled results showed that the use of probiotics was associated with a significant improvement in total nose symptom scores (SMD, -2.27; 95% CI, -3.26 to -1.29; P < 0.00001), itchy nose scores (SMD, -0.44; 95% CI, -0.80 to -0.07; P = 0.02), sneezing scores (SMD, -0.47; 95% CI, -0.84 to -0.10; P = 0.01), eye symptoms (SMD, -3.77; 95% CI, -5.47 to -2.07; P < 0.00001), and Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (SMD, -2.52; 95% CI, -4.12 to -0.92; P < 00001). However, the use of probiotics was not associated with the incidence of allergic rhinitis (RR, 0.9; 95% CI, 0.74-1.08; P = 0.26). The present study demonstrated that probiotics were effective and safe for improving pediatric allergic rhinitis symptoms and quality of life. However, probiotics could not prevent pediatric allergic rhinitis.

Comparing Postoperative Taping vs Customized 3D Splints for Managing Nasal Edema after Rhinoplasty.

Significant swelling after rhinoplasty can temporarily obscure results and lead to distress for patients and surgeons. We recently developed three dimensional (3D)-printed nasal splints that aim to protect the nose and limit edema by applying gentle compression. This prospective, randomized study compares postoperative nasal edema in patients being treated with traditional taping versus 3D-printed splints. Patients undergoing primary rhinoplasty (2019-2020) were randomized into two groups: taping versus 3D-printed splinting. For 12 weeks, patients either applied steri-strips to the dorsum and tip, or used 3D-printed splints, which were based on nasal simulations. The percentage change in volume (cm3) was calculated for the total nose, dorsum, and nasal tip at various time points. Nasal taping (n = 34) demonstrated a volume reduction of 4.8%, 9.9%, 10.0%, 10.3%, and 10.6% (compared with baseline) at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year, respectively. In contrast, the resolution of swelling with 3D splints (n = 36) was 5.0%, 8.6%, 11.0%, 14.9%, and 15.1% at the same time points. Inter-group comparison showed that 3D splints led to significantly less edema of the total nose at 6 months and 1 year (P ≤ 0.05), as well as consistent reductions in the tip and dorsum, specifically (1 year, P ≤ 0.1, 0.01, respectively). 3D-printed splints after rhinoplasty leads to a significant reduction of edema, most noticeable at 6 months and 1 year. This study suggests that customized 3D-printed splints offer an effective clinical alternative to traditional taping to reduce postoperative edema after rhinoplasty.

Midface Prelamination by Using a Three-Dimensional Cervicothoracic Prefabricated Flap.

The midface is an important area in aesthetics and function and a complex area to manage after burn injuries, trauma, and tumor resection. Traditional treatment to reconstruct midface defects involving the nose, lips, and cheeks requires multiple sequential flap operations but results in a patch-like appearance, which remains a major challenge for head and neck reconstructive surgeons. This article describes how the authors perform prelamination using the prefabricated cervicothoracic flap on the anterior chest for midface reconstruction. The key point of the authors' procedure is to three-dimensionalize the cervicothoracic prefabricated flap with flap folding; flap rotation; and cartilage grafts for coverage, lining, and support of the nose and lips. This technique may be indicated for extensive midface defects involving total nose and lip loss. It provides a uniform matched facial appearance and significant functional improvement. Donor-site morbidity and the need for multiple flap procedures could be reduced.

Defining Spatial and Temporal Resolution of Edema following Rhinoplasty: A Three-Dimensional Topographical Analysis.

Defining Spatial and Temporal Resolution of Edema following Rhinoplasty: A Three-Dimensional Topographical Analysis.

Three-Dimensional Rapid Printing-Assisted Individualized Total Nasal Reconstruction Based on a Database of Normal External Noses.

The nose is an unpaired facial structure. Applying three-dimensional rapid printing to total nose reconstruction is difficult because no paired structure is available for reference. In this study, three-dimensional laser scanning was used to create a database of normal external noses of Han Chinese individuals in East China to assist in total nose reconstruction. Three-dimensional laser scanning was used to create a database of normal external noses. Patients scheduled for nasal reconstruction had their measurements scaled according to head circumference and facial proportions to simulate a new reconstructed shape for the residual nose using this database. The personalized new shape was produced using rapid three-dimensional printing for preoperative evaluation and surgical design. In the database of external noses, the medium nose type was the main type among Han adults in East China (64.15 percent), followed by the narrow nose type (26.34 percent). Quantitative analysis showed that blood loss and operative times were lower in the study group than in the traditional surgery group ( p < 0.05). A postoperative nasal appearance satisfaction questionnaire showed that the appearance satisfaction rate, daily life measures, and perioperative comfort were significantly better in the study group ( p < 0.05). The database of external noses can bridge three-dimensional printing with total nasal reconstruction. The database has important clinical significance for optimizing the shape of the nose, reducing intraoperative blood loss, shortening the operative time, and improving patient satisfaction. This study provides new insight for the application of computer-guided three-dimensional scanning and rapid printing in organ reconstruction.

The Influence of Stress on Decision-Making: Effects of CRF and Dopamine Antagonism in the Nucleus Accumbens.

The actions of corticotropin-releasing factor (CRF) in the core of the nucleus accumbens including increasing dopamine release and inducing conditioned place preference in stress-naïve animals. However, following two-day, repeated forced swim stress (rFSS), neither of these effects are present, indicating a stress-sensitive interaction between CRF and dopamine. To ascertain the degree to which this mechanism influences integrated, reward-based decision making, we used an operant concurrent-choice task where mice could choose between two liquid receptacles containing a sucrose solution or water delivery. Following initial training, either a CRF or dopamine antagonist, α-helical CRF (9–41) and flupenthixol, respectively, or vehicle was administered intracranially to the nucleus accumbens core. Next, the animals underwent rFSS, were reintroduced to the task, and were retested. Prior to stress, mice exhibited a significant preference for sucrose over water and made more total nose pokes into the sucrose receptacle than the water receptacle throughout the session. There were no observed sex differences. Stress did not robustly affect preference metrics but did increase the number of trial omissions compared to their stress-naïve, time-matched counterparts. Interestingly, flupenthixol administration did not affect sucrose choice but increased their nosepoke preference during the inter-trial interval, increased trial omissions, and decreased the total nosepokes during the ITI. In contrast, microinjections of α-helical CRF (9–41) did not affect omissions or ITI nosepokes but produced interactions with stress on choice metrics. These data indicate that dopamine and CRF both interact with stress to impact performance in the task but influence different behavioral aspects.

Angiosarcoma of the Nose: A Case Report and Review of the Literature

Angiosarcoma is a rare and aggressive type of neoplasm that develops in the inner lining of blood vessels and lymph nodes. It accounts for less than 0.1% of head and neck malignancies. The treatment is based on surgery followed by wide field radiotherapy. Anyhow, the risk of local failure and recurrence as well as distant relapse remains high for this disease. We present in this paper a 55-year-old male patient case, with no significant medical history, who was referred for the evaluation of an erythematous and indurated plaque of 2.5 cm in the bridge of the nose. The physical exam showed no head or neck lymphadenopathy, and no nasal or oral mucosal involvement were noted. Multiple biopsies of the nose were taken, and the diagnosis of the specimens was angiosarcoma. MRI showed only soft tissues involvement and no distant metastasis were found on the CT scans. The patient was subsequently treated with total rhinectomy followed by total nose reconstruction. Thus, angiosarcoma of the nose is an uncommon pathology and it should be rapidly diagnosed. A delay in the diagnosis could result in significant therapeutic challenges. Surgery and postoperative radiotherapy are the two pillars of treatment.

Olfactory Perception and Different Decongestive Response of the Nasal Mucosa During Menstrual Cycle.

Sex hormones are known to have some influence on nasal functions, but their effect on the decongestive response of the nasal mucosa during menstrual cycle is still undetermined. The aim of this study was to examine the nasal physiology, the interconnectedness of olfactory and respiratory nasal function and the decongestive response of the nasal mucosa during menstrual cycle. This study included 101 healthy women aged 23.26 ± 4.81 years with a regular menstrual cycle. The nasal respiratory function and the decongestive response of the nasal mucosa were examined by rhinomanometry. Subjective sense of nasal obstruction and the subjective odor intensity were assessed by standardized questionnaires. The odor identification ability was assessed by Sniffin' Sticks test. Statistically significant higher values of nasal resistance (0.311 ± 0.107 Pa/cm3/s) and NOSE score (11.893 ± 13.83) were observed in the ovulatory phase compared to the luteal (0.281 ± 0.084 Pa/cm3/s and 9.029 ± 11.12). An odor identification test score was significantly higher in luteal phase (12.476 ± 1.48) compared to the ovulatory phase (11.971 ± 1.51), opposite of odor intensity. The difference of nasal resistance before and after decongestion was significantly higher in ovulatory phase (0.105 ± 0.097 Pa/cm3/s) compared to the luteal (0.084 ± 0.079 Pa/cm3/s). Correlation between subjective and objective parameters of the examinated nasal functions was not statistically significant in any menstrual phase. In the population of women studied, total nasal resistance and NOSE score were significantly lower in the luteal phase of the menstrual cycle. Odor identification was significantly higher in the luteal phase but odor intensity significantly higher in the ovulatory phase. The decongestive response of nasal mucosa was better in the ovulatory phase of the menstrual cycle.

Modified Cleft Lip Evaluation Profile (Mclep) Index For Unilateral Cleft Lip Repair Outcome Assessment In Surabaya Clp Center

Background: Cleft lip and/or palate is the most common craniofacial congenital anomaly encountered by the plastic surgeon. Both reconstruction and outcome assessment are challenging. This study aimed to assess the outcome of unilateral cleft lip repair in the Surabaya CLP Center.Methods: All patients who underwent unilateral cleft lip repair in 2017 were included in the study. Those without complete photographs at minimally 52 weeks after surgery were excluded. The photographs of patients taken at least one-year post-surgery were assessed using a modified cleft lip evaluation profile (MCLEP) index. The data were then analyzed using statistical software.Results: There were 38 subjects included in the study. There was no significant difference in the final scores obtained based on completeness of the cleft lip and the presence of alveolar cleft. The total nose score was significantly better in the left side cleft (p = 0.002). When palate cleft was absent, the total lip score (p = 0.038), the total nose score (p = 0.008), and total score (p = 0.000) were also significantly better.Conclusions: The unilateral cleft lip repair in CLP Center Surabaya yielded good and symmetrically acceptable results. The study failed to observe the different outcomes of unilateral cleft lip repair based on completeness of the cleft lip and the presence of alveolar cleft. However, the unilateral cleft lip repair outcome was significantly better in the absence of palate cleft.

Total nasal reconstruction with a forehead flap: Focusing on the facial aesthetic subunit principle

The nasal aesthetic subunit principle has been widely accepted as the standard for nasal reconstruction with forehead flaps. However, in our experience, one's impression of a reconstructed face can easily be represented by the nose's entire appearance rather than a single nasal component. Accordingly, we hypothesized that total nasal reconstruction focusing more on the facial aesthetic subunit principle would be superior to focal nasal subunit partial reconstruction. Here, we investigated the indication range of total nasal reconstruction and analyzed its effectiveness. Between July 2006 and December 2017, 32 patients who underwent total or subtotal nasal reconstruction were recruited. The total nasal reconstruction group (n = 20) was treated according to our modified facial aesthetic unit concept, while the subtotal reconstruction group (n = 16) was treated according to the nasal aesthetic subunit principle. Using retrospective reviews, we compared surgical details and aesthetic, and functional outcomes with visual analog scale scores. In aesthetic evaluation, nose contour (p = 0.009), nasal symmetry (p = 0.001), and nostril shape (p = 0.041) were superior in the total nasal reconstruction group. Satisfaction regarding the nose (p = 0.036) was significantly higher than that regarding the forehead and labial folds in the total group. Regarding function, there were no significant intergroup differences in nasal airflow, snoring, or olfaction. We suggest that total nasal reconstruction is not a strategy to avoid because of its aggressive nature. For selected suitable patients, the use of the total nose reconstruction focusing on our one nose concept can be a successful surgical option, and the reconstructed nose can be visualized as a real part of the face.

Microsurgical Reconstruction of the Nose: The Aesthetic Approach to Total Defects.

Reconstruction of complex defects involving nose and close facial units represents an aesthetic and functional challenge. Restoring satisfactory nasal shape, combining aesthetic, nasal function and patent airways is mandatory. In this paper, we describe our approach to total nose defects and we report our 20-year experience in microvascular nose reconstruction.Clinical cases are shown to illustrate different surgical techniques and the evolution of our approach. Nasal reconstruction procedures were performed on 21 patients between 2000 and 2020 using the radial forearm flap (RFF) or anterolateral thigh (ALT) flap. Reported reconstructions included total/subtotal nasal defects, caused by cancer resections. The key point of our approach is the expanded forehead flap for skin coverage. Reconstruction is completed by cartilage grafts to restore nasal framework and to shape nasal tip. Ancillary procedures were needed in some cases to optimize aesthetic outcomes. Twenty-one patients completed the multistage nasal reconstruction. The RFF flap was used in 56% of the cases (n = 11), while the ALT flap was used in 44% (n = 10) of our case series. No difference has been detected in the number of reconstructive stages required to achieve the final result comparing RFF and ALT reconstruction (3.3 vs. 3.1 reconstructive steps). Ancillary procedures were performed in 7 patients. Microvascular tissue transfer plays a key role in full-thickness nasal defects restoration. Comparing the two groups, both the RFF and ALT are effective and reliable options in lining reconstruction, although with different indications. Expanded forehead flap, combined to free cartilage graft, is our gold standard to provide external skin coverage to rebuild the nasal framework. According to our current approach, accurate preoperative planning, supported by modern technologic tools, multistage reconstruction, and ancillary procedures are useful to accomplish satisfactory functional and aesthetic outcomes.

The Combined Application of Database and Three-Dimensional Image Registration Technology in the Restoration of Total Nose Defect.

The purpose of this study is to present a virtual planning protocol based on the database and three-dimensional (3D) image registration technology for the restoration of the total nasal defect, and evaluate its feasibility and clinical efficacy. Patients were scanned with a FaceScan to obtain the 3D facial model which was stored in an Extensible Neuroimaging Archive Toolkit (XNAT) database. Personalized search and similarity evaluation were performed in the database to find a normal 3D facial model with the highest similarity to the patient's. Then, the 2 models were imported into the dedicated software for 3D image registration to get the 3D model of the nasal defect part and the preoperative planning 3D facial model of virtual restoration. Subsequently, the dimensionality reduction algorithm was conducted to transform the 3D model of the nasal defect to a 2D flatten one for determining the scope of the forehead flap during surgery. Four weeks after the insetting surgery of forehead flap pedicle, the postoperative 3D facial model was gained. At last, the clinical efficacy was evaluated by comparing the difference between the preoperative planning and postoperative 3D facial model. The nasal shapes of the patients were good after the operation, and the results revealed that the maximum error was ranging from 3.12 to 4.07 mm with the mean error from 0.92 to 1.04 mm. The database and 3D image registration technology provide a new approach for precisely determining the scope of total nasal defect and the forehead flap, which may be used for reference in the accurate restoration of other facial soft tissue defects.

3D facial soft tissue changes after rapid maxillary expansion on primary teeth: A randomized clinical trial.

The aim of the present randomized controlled trial (RCT) was therefore the tridimensional evaluation of soft tissue changes after rapid maxillary expansion in growing patients. Treated group comprised 17 patients (10 males and 7 females) with a mean age of 9.8±1.2years, and control group comprised 17 patients (13 males and 4 females) with a mean age of 9.1±2.1years. All patients of the treated group underwent maxillary expansion with Haas-type expander while patients of the control group underwent no treatment. 3D facial scans were acquired at T1, at the beginning of treatment or observation period, and at T2, 18months apart. The mean interval between the timepoints was 18.2±0.4months. The main differences between groups were reported in the nasal area. Nasal width (Alr-All) significantly increased in the treated group compared with the control. The increase in intereye and mouth width in the study group did not show differences with the control group. No significant differences were reported for lips' protrusion, angular measurements and facial heights between groups. The total nose volume difference was significantly higher in the treated group compared with control, and this result was related mainly to the significant increase in the nasal dorsum volume. Maxillary expansion produced significant increase in the nasal base and nasal volumes, but its clinical relevance is still questionable.

Neuropeptide S precursor knockout mice display memory and arousal deficits.

Activation of neuropeptide S (NPS) signaling has been found to produce arousal, wakefulness, anxiolytic-like behaviors, and enhanced memory formation. In order to further study physiological functions of the NPS system, we generated NPS precursor knockout mice by homologous recombination in embryonic stem cells. NPS-/- mice were viable, fertile, and anatomically normal, when compared to their wild-type and heterozygous littermates. The total number of NPS neurons-although no longer synthesizing the peptide - was not affected by the knockout, as analyzed in NPS-/- /NPSEGFP double transgenic mice. Analysis of behavioral phenotypes revealed significant deficits in exploratory activity in NPS-/- mice. NPS precursor knockout mice displayed attenuated arousal in the hole board test, visible as reduced total nose pokes and number of holes inspected, that was not confounded by increased repetitive or stereotypic behavior. Importantly, long-term memory was significantly impaired in NPS-/- mice in the inhibitory avoidance paradigm. NPS precursor knockout mice displayed mildly increased anxiety-like behaviors in three different tests measuring responses to stress and novelty. Interestingly, heterozygous littermates often presented behavioral deficits similar to NPS-/- mice or displayed intermediate phenotype. These observations may suggest limited ligand availability in critical neural circuits. Overall, phenotypical changes in NPS-/- mice are similar to those observed in NPS receptor knockout mice and support earlier findings that suggest major functions of the NPS system in arousal, regulation of anxiety and stress, and memory formation.

Median forehead flap - beyond classic indication

Introduction. The paramedian forehead flap is one of the best options for reconstruction of the median upper two-thirds of the face due to its vascularity, color, texture match and ability to resurface all or part of the reconstructed area. The forehead flap is the gold standard for nasal soft tissue reconstruction and the flap of choice for larger cutaneous nasal defects having a robust pedicle and large amount of tissue. Materials and Methods. We are reporting a clinical series of cutaneous tumors involving the nose, medial canthus, upper and lower eyelid through a retrospective review of 6 patients who underwent surgical excision of the lesion and primary reconstruction using a paramedian forehead flap. Results. The forehead flap was used for total nose reconstruction, eyelids and medial canthal reconstruction. All flaps survived completely and no tumor recurrence was seen in any of the patients. Cosmetic and functional results were favorable. Conclusions. The forehead flap continues to be one of the best options for nose reconstruction and for closure of surgical defects of the nose larger than 2 cm. Even though is not a gold standard, median forehead flap can be an advantageous technique in periorbital defects reconstruction.

Clinical efficacy of the different repairs of nasal tissue defects

Objective To analyze the clinical efficacies of repairing nasal tissue defect. Methods The 17 cases of nasal defects were repaired. According to the difference of nasal tissue defect, different treatments were used, which included total nose reconstruction or partial nose reconstruction with forehead flap, transplantation of auricle composite flap, medpor framework implantation, nasolabial flap transferring, full-thickness skin graft, skin expander embedded in the forehead or cheek, extraction of costal cartilage or nasal septal cartilage and columella lengthening. Results The follow-up was from 2 months to 6 years. Four cases with nose reconstruction had a good appearance, but exposure of framework was found in two of them, which was healed after repairing. Auricle composite flaps were completely survived in three cases and necrosis was found in one case. Six of seven cases had a completely survived nasolabial flaps, and the remaining one had a partial necrosis. The full-thickness skins were survived in the two cases. The four cases who received expander embedded had a expectant result. Random flaps were completely survived in five cases. Columella lengthening in two cases had a stable result. Five cases had received two or more than two times operations. During the follow-up period, the 17 cases were satisfied with the operative results. Conclusions The nasal tissue defect not only presents in a single nasal subunit, but also happens in multi-subunits. Flap transferring, graft of auricle composite tissue, medpor framework implantation and nose reconstruction could be used in the repairing procedures. Key words: Nose; Tissue defect; Subunit

Radiofrequency volumetric inferior turbinate reduction: long-term clinical results.

SUMMARYThe aim of our study was to assess long-term results of radiofrequency volumetric tissue reduction of inferior turbinates (RVTR). We performed a prospective long-term longitudinal evaluation of 305 patients affected by rhinitis (114 allergic and 191 non-allergic) who were unresponsive to medical treatment and underwent RVTR (January 2004 - December 2010). Subjects were followed for a mean period of 39.70 ± 19.41 months (range 24-60). Patients completed the NOSE-scale questionnaire pre- and post-operatively after 1 month and yearly for 5-years. Recurrence was assumed if the post-operative total NOSE score increased by at least 75% during follow-up and the patient restarted medical treatments. Estimation of relapse over time was performed by Kaplan-Meyer analyses. We documented overall good satisfaction of patients regarding the procedure, with a good rate of pain control and a low rate of complications. Post-operatively there was a significant improvement in nasal stuffiness, nasal obstruction and mouth breathing (p < 0.05). We observed a worsening trend for symptoms after 36 months with progressive increasing rate of recurrences that were significantly higher in allergic than non-allergic patients (p < 0.05). We also observed a slight worsening trend of global satisfaction of patients. Our study confirms the minor discomfort and low risk of side effects of RVTR. Our data showed good efficacy of the procedure in the majority of patients for at least 36 months after surgery, and in fact in this time period the cumulative probability to remain relapse-free was up to 0.8. In the following 2 years, we observed a worse temporal trend in term of recurrence rate, and in particular in allergic patients with a significant difference vs non-allergic individuals (p < 0.05).

Reconstruction of Mid-facial Defects Using Facial Prostheses Supported by Dental Implants

Malignant tumors which affect nasal structures are uncommon. They represent about 0.2% of all cancers and are more than twice as prevalent in males. Squamous cell carcinoma is the most common type of nasal cancer. However, basal cell carcinoma, melanoma, sarcoma and inverting papilloma can involve nose and/or para-nasal sinuses too. Although rare, these pathologies are the most frequent cause for acquired defects of the nose. In this light, the need to obtain clear resection margins obliges surgeon to perform extensive nose amputations. This report describes the case of a 63 years old man affected by squamous cell carcinoma of the nose. A total nose amputation was carried out due to the extension of the tumor. Nasal reconstruction was performed with an implant-retained prosthesis. Three dental implants were used for anchoring the nasal prostheses. This technology is safe and it ensures optimum esthetic results.