Auricular composite grafting to repair nasal vestibular stenosis

Abstract

Nasal vestibular stenosis is defined as a narrowing of the nasal inlet resulting in airway obstruction. Causes include nasal trauma, infection, and iatrogenic insults. The objectives of this article are to illustrate nasal vestibular stenosis and to analyze common causes and surgical treatments. The operative technique of the senior author (M.S.K.), will be presented. Donor site morbidity and patient outcomes will be discussed. Sixteen patients were seen during a 5-year period. Eleven women and 5 men were evaluated and found to have nasal vestibular stenosis. Three patients had stenosis as a result of nasal fracture or laceration. Stenosis developed in the remaining 13 as a result of nasal surgery. All patients underwent auricular composite grafting, and grafts took in 100%. Partial skin slough occurred in up to 50%; however, re-epithelialization was seen within 3 weeks. Complications were seen at the donor site. Immediate patient satisfaction was seen and continues during long-term follow-up.

Treatment of complete nasal vestibule stenosis with vestibular stents and mitomycin C

“…4 Suggested reconstructive options include use of modified z-plasty, skin grafts, local myocutaneous flaps, septal cartilage flaps, mucosal flaps from the palate, and composite cartilage grafts. 5 These all require general anesthesia or prolonged monitored anesthesia care sedation.…”

Surgical Repair of Nasal Vestibular Stenosis A Case Report

“…Multiple surgical approaches have been described for repair like modified Z-plasty, skin grafts, and intranasal local flaps 3,4 . Raising vestibular pedicle flaps, a technique giving good results, is used in our case report, and has showed satisfactory results 4,5 . This procedure results in improvement of nasal obstruction functionally and aesthetically.…”

Nasal Continuous Positive Airway Pressure Injuries

“…3,4 In the present case, the columella soft tissue was spared, but scarring of the soft tissue triangle resulted in significant growth restriction and deformity of the ala. A comparable deformity is seen in some adult patients with unilateral cleft lip or nasal deformity. 5,6 The nostril that was initially laterally displaced at birth may become stenotic after cleft lip repair owing to the peri-alar nasal incision used to medialize the alar base. 5,6 To improve nostril width for this patient, the alar base was lateralized.…”