M Daya1. 1. Department of Plastic and Reconstructive Surgery, Nelson R. Mandela School of Medicine, University of Kwazulu-Natal, Durban, South Africa. dayam@iafrica.com
Abstract
BACKGROUND: The treatment of nostril stenosis is difficult. The aim is to restore facial profile and balance and an adequate airway that is not prone to restenosis. METHODS: Fourteen patients with an age distribution of 18 months to 71 years are presented. The management of the patients involved a surgical release of the nose and creation of a nostril. The nostril was reconstructed by one of a number of methods: (a) The scar was cored out and the passage either lined with skin graft or allowed to re-epithelialise. (b) The nostril opening was increased in size by z plasty technique. (c) The nostril was created by a local flap. The aim of the surgery was to create a nostril opening of adequate size to fit a nasal stent. The nasal stent was then serially upgraded in size to expand the opening of the nostril and the surrounding tissue. The upgrade in the size of the nostril was discontinued when it matched for age or the size of the contralateral one. RESULTS: The results obtained were more than satisfactory. There was adequate long term maintenance of the nostril size in all except one of the patients. Overall, the serial upgrade in the size of the stent helped emulate the growth of the lower third of the nose in a growing child. CONCLUSION: The advocated management appears to a good solution to a very difficult problem. But continual use of the stent and patient compliance can be a drawback.
BACKGROUND: The treatment of nostril stenosis is difficult. The aim is to restore facial profile and balance and an adequate airway that is not prone to restenosis. METHODS: Fourteen patients with an age distribution of 18 months to 71 years are presented. The management of the patients involved a surgical release of the nose and creation of a nostril. The nostril was reconstructed by one of a number of methods: (a) The scar was cored out and the passage either lined with skin graft or allowed to re-epithelialise. (b) The nostril opening was increased in size by z plasty technique. (c) The nostril was created by a local flap. The aim of the surgery was to create a nostril opening of adequate size to fit a nasal stent. The nasal stent was then serially upgraded in size to expand the opening of the nostril and the surrounding tissue. The upgrade in the size of the nostril was discontinued when it matched for age or the size of the contralateral one. RESULTS: The results obtained were more than satisfactory. There was adequate long term maintenance of the nostril size in all except one of the patients. Overall, the serial upgrade in the size of the stent helped emulate the growth of the lower third of the nose in a growing child. CONCLUSION: The advocated management appears to a good solution to a very difficult problem. But continual use of the stent and patient compliance can be a drawback.