Nasal Reconstruction in Granulomatosis with Polyangiitis: A Two Decade Review

Abstract

Background: Granulomatosis with polyangiitis (GPA) leads to progressive destruction of the nasal tissues resulting varying degrees of saddle deformity and nasal obstruction. Reconstructive techniques are numerous, but there are no large series reporting their results. Objective: This study sought to measure complications and outcomes after rhinoplasty for GPA. Methods: We conducted a retrospective review of 42 patients with GPA who underwent nasal reconstruction of saddle nose deformity between 2005 and 2019 using primarily costal cartilage and soft tissue grafts. Results: Thirty-six patients met the criteria for inclusion. All were followed for a minimum of 12 months. Six patients required revision surgery due to infection or GPA flare ups. Five patients had complications. All patients were given a questionnaire at 12 months to rate their degree of satisfaction with their appearance and breathing. Conclusion: The findings of this study suggest that the use of strong cartilage grafts and the timing of surgery result in improvement in breathing and appearance after rhinoplasty in patients with GPA. Clinical Trial Registration number: REB # 21-125.

Rhinoplasty for Sinonasal Deformities in Granulomatosis with Polyangiitis: A Systematic Review and Meta-Analysis

“…In our systematic review and meta-analysis, 16 studies were conducted on nasal reconstruction in individuals diagnosed with GPA in 6 different countries, including ~136 patients; their ages ranged from 21 to 56 years. 12,14,16,[18][19][20][28][29][30][31][32][33][34][35][36][37] Study designs encompassed 7 case reports, 5 retrospective cohort studies, and 4 case series. The duration of follow-up across the studies varied from 1 to 15 years.…”

Deformidade do nariz em sela em doenças reumatológicas: Uma revisão

“…No presente estudo, 4 artigos científicos, dentre eles três revisões de literatura e um estudo de coorte retrospectivo, mencionaram a relação da GPA com a perda progressiva do suporte nasal e a ocorrência do nariz em sela, de modo que a literatura descreve que mais da metade dos pacientes com GPA apresentam lesões localizadas na cavidade e nos seios paranasais (Gantous & Garcia 2022;Coordes et al, 2018). Além disso, relata-se que deformidade nasal pode ser constatada em cerca de 23% dos pacientes com GPA considerando a análise retrospectiva promovida por estudo envolvendo 120 pacientes assistidos em centro terciário de atendimento otorrinolaringológico (Cannady et al, 2009apud Coordes et al, 2018.…”