A Congenital Isolated Alar Cleft

Congenital isolated alar defects are extremely rare, occurring in approximately 1 in 20,000 to 40,000 live births. The patients are presented here of 2 pediatric patients operated on for congenital isolated alar defect. The reconstruction of congenital isolated alar defects was made in a 3-layered fashion. The skin defects were covered using the Mutaf triangular closure technique in which 2 cutaneous local flaps are designed in an unequal Z-plasty manner. Conchal cartilage graft was used between the skin and mucosal closure to replace the missing part of the lower lateral cartilage in these patients. The early results were promising in Patient 1, but sufficient improvement was detected in the alar cartilage postoperative follow-up period in Patient 2. Hence, this patient required revision 1 to 2 years postoperatively. This technique provides excellent aesthetic and functional results, except for this problem in Tessier 2 cleft patients. The use of the Stair step flap technique with Mutaf triangle closure technique achieved cosmetically and functionally excellent results in the reconstruction and repair of a large, irregular, narrow cleft, in the inadequate rotation of the lateral part of the lower lateral cartilage. However, because of this problem, evaluation of the long-term follow-up of patients is necessary.

Section: Discussionmentioning

confidence: 99%

Reconstruction of Congenital Isolated Alar Defect Using Mutaf Triangular Closure Technique in Pediatric Patients

Temel

Günal

Kahraman

2016

“…4,5 These placodes grow as convex thickenings of the surface ectoderm at the end of the fourth week. 5 Then, primitive nasal pits are reshaped by the collapse of the central portions of the placodes. Medial and lateral nasal processes appear around the nasal pits through mesenchymal proliferation.…”

Section: Discussionmentioning

confidence: 99%

“…Nasal bones, upper lateral cartilages, and the lateral crura of LLC develop from the lateral nasal process. 5 The nasal apex and dorsum derive from the frontonasal prominence. 1 Developmental defects in the lateral nasal processes result in anomalies of the alar region.…”

Section: Discussionmentioning

confidence: 99%

“…4 This lesion is commonly found in the maxilla and mandible and can become quite large because of its potential for significant expansion, extension into adjacent tissues, and rapid growth. 5,6 Recurrence rates ranging anywhere from less than 10% to more than 60% have been reported. 7,8 Despite high recurrence of OKCs, few studies focused on the correlation of radiographic and clinical features of them with recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Congenital Isolated Aplasia of Lower Lateral Cartilage and Reconstruction Using Dorsal Hump Material

Temiz

Yeşïloğlu

Sarıcı

et al. 2014

Congenital nasal abnormalities are very rare in the literature. There are 3 reported cases of isolated partial lower lateral cartilage defects. In this article, we report the case of a patient with congenital complete absence of the lower lateral cartilage. The patient had severe external nasal valve dysfunction and a concavity of the alar vault, even in the resting position. The defect was reconstructed using resected and reshaped nasal dorsal hump material. At the end of a 12-month follow-up period, the patient was satisfied with the functional and aesthetic results of the operation. No external or internal nasal valve collapse occurred during inspiration. Such developmental abnormalities may be syndromic and require special attention for reconstruction.

“…The size of the defect may vary from a simple cleft to a wide defect including the entire ala nasi. 1,2 Here, we present a patient with a wide CIAD in whom a new procedure, namely Mutaf's triangular closure technique, was used for the reconstruction of the alar defect.…”

mentioning

confidence: 99%

A New Technique for Reconstruction of a Congenital Isolated Alar Defect

Mutaf

Günal

2010

Congenital isolated alar defect (CIAD) is an extremely rare anomaly causing a remarkable aesthetic deformity. Up to today, only 6 previous cases have been reported, and there has been no technique approved as a criterion standard for the reconstruction of this anomaly yet. Here, we present a patient with a wide unilateral CIAD reconstructed with a new procedure, namely Mutaf's triangular closure technique. A 16-year-old adolescent boy was admitted to our clinic with a CIAD of 1.4 cm x 1.8 cm located on the left side. The reconstruction of the defect was done in a 3-layered fashion. The skin defect was covered by using the Mutaf's triangular closure technique in which 2 cutaneous local flaps designed in an unequal Z-plasty manner were used. The mucosal closure was achieved with a single mucosal transposition flap elevated from the superolateral alar region. A septal cartilage graft was placed between the skin and mucosal closure to replace the missing part of the lower lateral cartilage. Flaps healed with no complication. At 1 year after surgery, there was a cosmetically and functionally excellent result with almost symmetrical nostrils and minimal scar formation. Providing an aesthetic and anatomic reconstruction with alike local tissues, Mutaf's triangular closure procedure seems to be a useful option for reconstruction of the CIADs.