Total nasal skeletal reconstruction disfigured by granulomatosis with polyangitis (wegener granulomatosis)

• Published in: Plastic and reconstructive surgery. Global open Vol. 3; no. 2; p. e308
• Main Authors: Hafezi, Farhad, Naghibzadeh, Bijan, Ashtiani, Abbas Kazemi, Nouhi, Amir Hossein, Naghibzadeh, Ghazal
• Format: Report
• Language: English
• Published: 01.02.2015
• ISSN: 2169-7574; 2169-7574
• DOI: 10.1097/GOX.0000000000000278

BACKGROUNDNasal deformity is a common disorder in Wegener granulomatosis, which is produced by polyangitis of medium-sized vessels. This process may cause necrosis and destruction of the nasal mucosa and osteocartilaginous framework. At this time, there is a lack of published data on nasal deformities associated with Wegener granulomatosis. METHODSWe present a 53-year-old woman with completely necrotized nasal lining and osteocartilage. The patient had a history of granulomatosis with polyangitis that was currently in remission. We reconstructed the patient's nose with fifth and sixth rib cartilages over 3 successive surgeries over a 2-year period. RESULTSDuring the 3-year follow-up period, neither infection nor significant cartilage graft resorption was observed, and the aesthetic result was acceptable both to the patient and her physicians. CONCLUSIONSIn spite of contamination to the nasal lining and immune-compromising medications, nasal reconstruction is usually successful when considering these factors. Access to strong and abundant fifth or sixth rib cartilage presents an opportunity to reconstruct nasal destruction due to iatrogenic or autoimmune processes.