Nasal reconstructive surgery for vasculitis affecting the nose: our two-centre international experience

Unadkat, Samit; Pendolino, Alfonso Luca; Kwame, Ivor; Swift, A. C.; Pusey, Charles D.; Gantous, Andres; Andrews, Peter

doi:10.1007/s00405-020-06180-8

Cited by 7 publications

(15 citation statements)

References 21 publications

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“…Surgical treatment of nasal deformities is done after a long period of remission. It includes the insertion of the silastic button and reconstruction of the dorsum of the nose with costal cartilage [19] .…”

Section: Discussionmentioning

confidence: 99%

An atypical presentation of granulomatosis with polyangiitis: A case report

Maqbool¹,

Maqbool²,

Maqbool³

et al. 2023

Radiology Case Reports

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Section: Discussionmentioning

confidence: 99%

An atypical presentation of granulomatosis with polyangiitis: A case report

Maqbool¹,

Maqbool²,

Maqbool³

et al. 2023

Radiology Case Reports

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“…The surgical results obtained in this study are comparable with those reported in other series. 2 , 3 , 7 , 10 , 19 , 29 , 39 Rhinoplasty in the presence of an autoimmune disorder such as GPA can be successful in restoring structure and cosmesis to the nose as well as in improving breathing. The operation is fraught with an increased complication rate due to the impaired blood supply caused by the vasculitis, the hypercoagulable state that is inherent in GPA and the immune modulating medications that patients are usually on.…”

Section: Discussionmentioning

confidence: 99%

“…The mild to moderate saddle deformity (type I and II) with minimal or no foreshortening of the nose will result in a better cosmetic and functional result than that attainable in more advanced cases. 29 The timing for surgery is of paramount importance. In general, patients undergoing surgery must be in a sustained remission for 6 months or more or on a stable low-dose maintenance immunosuppressive regimen.…”

Section: Introductionmentioning

confidence: 99%

Nasal Reconstruction in Granulomatosis with Polyangiitis: A Two Decade Review

Gantous

Garcia

2022

Facial Plastic Surgery & Aesthetic Medicine

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Background: Granulomatosis with polyangiitis (GPA) leads to progressive destruction of the nasal tissues resulting varying degrees of saddle deformity and nasal obstruction. Reconstructive techniques are numerous, but there are no large series reporting their results. Objective: This study sought to measure complications and outcomes after rhinoplasty for GPA. Methods: We conducted a retrospective review of 42 patients with GPA who underwent nasal reconstruction of saddle nose deformity between 2005 and 2019 using primarily costal cartilage and soft tissue grafts. Results: Thirty-six patients met the criteria for inclusion. All were followed for a minimum of 12 months. Six patients required revision surgery due to infection or GPA flare ups. Five patients had complications. All patients were given a questionnaire at 12 months to rate their degree of satisfaction with their appearance and breathing. Conclusion: The findings of this study suggest that the use of strong cartilage grafts and the timing of surgery result in improvement in breathing and appearance after rhinoplasty in patients with GPA. Clinical Trial Registration number: REB # 21-125.

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“…In our systematic review and meta-analysis, 16 studies were conducted on nasal reconstruction in individuals diagnosed with GPA in 6 different countries, including ~136 patients; their ages ranged from 21 to 56 years. 12,14,16,[18][19][20][28][29][30][31][32][33][34][35][36][37] Study designs encompassed 7 case reports, 5 retrospective cohort studies, and 4 case series. The duration of follow-up across the studies varied from 1 to 15 years.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Rhinoplasty for Sinonasal Deformities in Granulomatosis with Polyangiitis: A Systematic Review and Meta-Analysis

Alanazi,

Alenezi,

Alanazy

et al. 2023

Journal of Craniofacial Surgery

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Background: Granulomatosis with polyangiitis (GPA) is a vasculitis that affects respiratory and kidney vessels. It primarily involves the nose and sinuses but can progress systemically. Granulomatosis with polyangiitis causes severe nasal deformities, impacting aesthetics and breathing. Literature focuses on rhinoplasty for saddle nose deformities in non-GPA patients, but its suitability for GPA patients remains uncertain. Aim: Our study aims to assess the effectiveness and safety of rhinoplasty in GPA patients by analyzing the existing literature. Methods: Four databases were searched; 2 reviewers independently screened the retrieved references, then relevant data for our study were extracted. Categorical outcomes were analyzed using pooled proportions and 95% CI. Statistical heterogeneity was assessed using the I 2 statistics χ2 test with a P-value lower than 0.1 indicating heterogeneity. Results: In our systematic review and meta-analysis, we incorporated 16 studies encompassing 136 patients who underwent nasal reconstruction as part of their treatment for GPA. The collective findings indicate a favorable success rate for rhinoplasty, with a pooled ratio of 89% (95% CI: 84%, 95%). The rate of revision surgeries was relatively low, with a pooled rate of 19% (95% CI: 12%, 26%). Furthermore, rhinoplasty demonstrated comparatively lower rates of recurrence (pooled rate: 22%, 95% CI: 3%, 42%) and complications (pooled rate: 12%, 95% CI: 7%, 18%). Conclusion: Rhinoplasty benefits GPA patients with saddle nose deformity and septal perforation with high success rates and low recurrence, revision, and complication outcomes. However, more research is needed for validation and refinement.

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Nasal reconstructive surgery for vasculitis affecting the nose: our two-centre international experience

Cited by 7 publications

References 21 publications

An atypical presentation of granulomatosis with polyangiitis: A case report

An atypical presentation of granulomatosis with polyangiitis: A case report

Nasal Reconstruction in Granulomatosis with Polyangiitis: A Two Decade Review

Rhinoplasty for Sinonasal Deformities in Granulomatosis with Polyangiitis: A Systematic Review and Meta-Analysis

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