Reconstructive Techniques for the Saddle Nose Deformity in Granulomatosis With Polyangiitis

Ezzat, Waleed H.; Compton, Rebecca A.; Basa, Krystyne; Levi, Jessica R.

doi:10.1001/jamaoto.2016.3484

Cited by 20 publications

(33 citation statements)

References 32 publications

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“…Systematic reviews demonstrate that saddle nose reconstruction in GPA patients with minimal or no local disease is a safe procedure and that L-strut grafts appear to be a more robust technique in the setting of GPA. 29 , 40 The risk of complication decreases with the use of a L-shaped strut reconstruction technique when compared to reconstruction using multiple smaller grafts. 40 The L-strut also affords better stability which resists the resultant scarring and contracture caused by surgery, whereas the placement of smaller and less secure grafts does not offer this stability.…”

Section: Resultsmentioning

confidence: 99%

“…They observed that autologous costal cartilage grafts were associated with better transplant success rates (83%) compared with bone grafts (calvarial bone graft; transplant success rate 75%) and irradiated materials showed complete reabsorption long term. 30 Conversely, Ezzat et al 40 observed a slightly lower complication rate with calvarial bone grafts (11%) compared with those reconstructed with costal cartilage (19%).…”

Section: Saddle Nose Deformity Repairmentioning

confidence: 96%

“…29,40 The risk of complication decreases with the use of a L-shaped strut reconstruction technique when compared to reconstruction using multiple smaller grafts. 40 The L-strut also affords better stability which resists the resultant scarring and contracture caused by surgery, whereas the placement of smaller and less secure grafts does not offer this stability. 40 However, the debate continues over which technique is the best for nasal reconstruction.…”

Section: Saddle Nose Deformity Repairmentioning

confidence: 99%

“…40 The L-strut also affords better stability which resists the resultant scarring and contracture caused by surgery, whereas the placement of smaller and less secure grafts does not offer this stability. 40 However, the debate continues over which technique is the best for nasal reconstruction. 12,29 The best graft to use for reconstruction, if autologous (autograft) or non-autologous (allograft) grafts, and in this case, if cartilage or bone, is still matter of discussion.…”

Section: Saddle Nose Deformity Repairmentioning

confidence: 99%

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The role of surgery in antineutrophil cytoplasmic antibody–associated vasculitides affecting the nose and sinuses: A systematic review

et al. 2020

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Background: The ear, nose and throat region has been reported to be one of the commonest sites involved in antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis diseases and often precedes the diagnosis of ANCA–associated vasculitis by many months. Although treatment for ANCA–associated vasculitis primarily requires systemic immunosuppressive therapy, there are specific indications for sinonasal surgery during the course of the disease process. The three major roles for surgery in sinonasal vasculitis are to aid diagnosis through biopsy, enable symptom relief and nasal reconstructive surgery consideration when in remission. Purpose: The aim of this systematic review is to provide an overview of the surgical procedures which can be performed in patients with ANCA–associated vasculitis presenting with sinonasal involvement. Materials and methods: A systematic literature search was performed for scientific articles on MEDLINE (PubMed Advanced MEDLINE Search) and EMBASE. The search included all articles up to April 2020. Conclusion: Surgical intervention during the active phase of ANCA–associated vasculitis disease can improve the patient’s symptoms and enable histological diagnosis. The surgical decision to manage the nose requires a multidisciplinary approach involving the vasculitis specialist and the ear, nose and throat surgeon. Nasal reconstruction can be performed to restore form and function but only when the disease is in remission so as to maximise success and minimise complications.

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Section: Resultsmentioning

confidence: 99%

Section: Saddle Nose Deformity Repairmentioning

confidence: 96%

Section: Saddle Nose Deformity Repairmentioning

confidence: 99%

Section: Saddle Nose Deformity Repairmentioning

confidence: 99%

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The role of surgery in antineutrophil cytoplasmic antibody–associated vasculitides affecting the nose and sinuses: A systematic review

et al. 2020

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“…A meta-analysis by Ezzat et al has shown that reconstruction in patients with vasculitic diseases can be performed safely. 10 The skin is often placed under tension when stretching it over the new nasal framework. Smokers, patients who have had prior rhinoplasties, and those with vasculitis are at much higher risk of vascular insufficiency and damage to the skin flap.…”

Section: Workupmentioning

confidence: 99%

Correction of the Saddle Nose Deformity

Hamilton

2020

Facial plast Surg

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Saddle nose deformities are among the most challenging problems in rhinoplasty. These patients have often had previous surgery and may have complicated medical histories. Reconstructing the septum is a necessary prerequisite to correcting the contour of the nose. With proper planning and thoughtful execution, patients suffering from disfiguring saddle noses can be safely operated on—even those with vasculitic diseases.

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