Neurofibroma is an autosomal dominant disorder which has major criteria such as hyperpigmentation (cafe-au lait spots), cutaneous and subcutaneous tumors and bone deformities. In this report, a case of multifocal intraosseous neurofibroma in a 16-year-old male with right facial asymmetry, multiple unerupted maxillary posterior teeth and a previous history of infratemporal and orbital neurofibroma is presented. The majority of reported cases occurred in the posterior portion of the mandible and a limited number in the maxilla. Cone beam CT (CBCT) was performed for better evaluation of the extension and form of the maxillary and mandibular lesions. This report presents a rare situation of simultaneous peripheral neurofibromatosis (NF) and multifocal intraosseous NF in the mandible, maxilla and orbits and also focuses on advanced imaging findings of bony and soft tissue neurofibroma.

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Background Nasal sill is one of the components of the alar ring, affecting the esthetic outcomes of rhinoplasty; accordingly, we developed a novel technique to adjust defects in this area and compared it with the available techniques. Methods Our technique was based on creating a tunnel access to the nasal sill area through an incision made in the lower third of the columella using the open approach or through a nostril base incision in patients, who underwent alar base reduction, followed by insertion of a cartilaginous graft into the marked defect area. Results A total number of 54 patients with a defect in the nasal sill area were included in this study. Thirty-one patients underwent open rhinoplasty with the sill approach from the lower third of the columella, while 23 patients underwent rhinoplasty with a nostril base approach for nasal sill augmentation procedure. There were no reports of patient dissatisfaction, infection, bleeding, sensory dysfunction, or remaining asymmetry of the sill area. Conclusion Based on the findings of the present study, this technique can be successfully used in reconstructing the nasal sill area with minimal complications and morbidity.

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