R Gürkov1, A Berghaus. 1. Department of Oto-rhino-laryngology, Head and Neck Surgery, Ludwig Maximilians University, Munich, Germany. rguerkov@med.uni-muenchen.de
Abstract
INTRODUCTION: Sarcoidosis can lead to devastating nasal deformities and impairment of nasal respiratory function. There is only very little published experience with nasal reconstruction in this disease entity. In general, a cautious attitude prevails out of fear of complications or failure due to the underlying granulomatous inflammation. CASE REPORT: A 57-year-old lady presented to our institution with a 20-year history of sarcoidosis with sinunasal involvement. The findings included a saddle nose deformity, absent nasal septum and conchae, left-sided alar collapse and cutaneous involvement of the nasal tip with discoloration. In a first procedure, we performed a reconstructive nasal surgery with porous polyethylene grafts. In a second procedure, we used a paramedian forehead flap for a partial nasal reconstruction. The functional and asthetic improvement was very satisfactory for the patient during the 2-year follow-up period. CONCLUSION: This is the first reported use of a forehead flap in nasal sarcoidosis. It demonstrates that major reconstructive nasal surgery and implantation of porous polyethylene grafts can successfully be performed in patients with sinonasal sarcoidosis during remission.
INTRODUCTION:Sarcoidosis can lead to devastating nasal deformities and impairment of nasal respiratory function. There is only very little published experience with nasal reconstruction in this disease entity. In general, a cautious attitude prevails out of fear of complications or failure due to the underlying granulomatous inflammation. CASE REPORT: A 57-year-old lady presented to our institution with a 20-year history of sarcoidosis with sinunasal involvement. The findings included a saddle nose deformity, absent nasal septum and conchae, left-sided alar collapse and cutaneous involvement of the nasal tip with discoloration. In a first procedure, we performed a reconstructive nasal surgery with porous polyethylene grafts. In a second procedure, we used a paramedian forehead flap for a partial nasal reconstruction. The functional and asthetic improvement was very satisfactory for the patient during the 2-year follow-up period. CONCLUSION: This is the first reported use of a forehead flap in nasal sarcoidosis. It demonstrates that major reconstructive nasal surgery and implantation of porous polyethylene grafts can successfully be performed in patients with sinonasal sarcoidosis during remission.