Vertical Facial Distraction in the Treatment of Arhinia

Feledy, Jules A.; Goodman, Cynthia M.; Taylor, Terry D.; Stal, Samuel; Smith, Brian G.; Hollier, Larry H.

doi:10.1097/01.prs.0000122218.78595.97

Cited by 25 publications

(25 citation statements)

References 23 publications

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“…The ideal time for nose reconstruction in hemiarrhinia or arrhinia is during adolescence; however, an initial reconstruction during preschool age is required to achieve social integration. 5,9 Patient 1 arrived to our department before preschool age. We started treatment that included reconstruction during childhood with a second surgery when the facial growth is completed.…”

Section: Discussionmentioning

confidence: 99%

Use of Distraction Osteogenesis in Arrhinia

Prada

Mendoza²

2014

Journal of Craniofacial Surgery

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Nasal malformations such as hemiarrhinia and arrhinia have a very low incidence, although many treatment protocols have been described. In this article, we describe 2 surgical techniques to treat arrhinia depending on the age at the beginning of treatment. In our practice, we use Le Fort III osteotomy with distraction osteogenesis as a pillar of the reconstruction because it allows to improve anteroposterior and vertical projections of the midface, giving a proper platform for nasal reconstruction, decreasing the number of interventions. We report a patient with a hemiarrhinia who has completed appropriate reconstruction results and a patient with total arrhinia in whom the distraction was achieved to create a nasal bone support and improve midface projection.

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Section: Discussionmentioning

confidence: 99%

Use of Distraction Osteogenesis in Arrhinia

Prada

Mendoza²

2014

Journal of Craniofacial Surgery

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“…However, no consistent gene mutations have been discovered; therefore, genetic testing is not yet available. The chromosomal analysis in patients with arhinia showed normal results, excepting 3 cases that had abnormal karyotypes: mos46,XX/47,XX,+9; 1046,XY,inv(9); 1146,XX,t(3;12) (q13.2;p11.2) [10]. In addition to the karyotype, the all reported cases are normal.…”

Section: Discussionmentioning

confidence: 99%

“…If the height of maxillary is high enough, the patient only needs Le-Fort II osteotomy; If not, the patient should have a Le-Fort II osteotomy first, and then extend it along the maxillary bone. The external distraction device provides additional facial height in a reasonable time period and has sufficient midfacial vertical length to accommodate a nasal reconstruction [10]. There are 2 advantages of lengthening of maxilla: it can provide enough maxillary height for the reconstruction of nasal cavity, and it achieves suitable aesthetic proportions [11].…”

Section: Discussionmentioning

confidence: 99%

Congenital arhinia: A rare case

Zhang

Yang-hong

et al. 2014

Am J Case Rep

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Patient: Male, 4 monthsFinal Diagnosis: Congenital arhyniaSymptoms: Absence of the noseMedication: —Clinical Procedure: —Specialty: Pediatrics and Noenatology • GeneticsObjective:Congenital defectsBackground:Congenital nasal absence (arhinia) is an extremely rare malformation. Arhinia causes severe airway obstruction and poor feeding in the affected neonate. There is an association with other facial anomalies, especially defects of the eyes, ears, palate, and midline defects.Case Report:A full-term boy was born via an uncomplicated vaginal delivery. The mother was 40 years old and had a normal pregnancy. The mother had 4 previous uncomplicated pregnancies. There was no history of drug use during pregnancy.Conclusions:Congenital arhinia is a rare defect of embryogenesis, often associated with other anomalies that significantly influence the immediate and long-term outcomes of the neonate. It is a potentially life-threatening condition and requires the presence of a highly skilled neonatal resuscitation team at the time of delivery. Parental counseling is vital and a multidisciplinary team approach is required to optimize neonatal outcome.

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“…Canalization of nasal passage or tracheostomy may be required depending on severity of neonatal respiratory distress. [127]…”

Section: Discussionmentioning

confidence: 99%