Saddle nose deformity and septal perforation in granulomatosis with polyangiitis

@article{Coordes2018SaddleND,
  title={Saddle nose deformity and septal perforation in granulomatosis with polyangiitis},
  author={Annekatrin Coordes and Suzanne M. Loose and VM. Hofmann and Grant S. Hamilton and Frank Riedel and Dirk Jan Menger and Andreas E. Albers},
  journal={Clinical Otolaryngology},
  year={2018},
  volume={43},
  pages={291 - 299}
}
Patients who have granulomatosis with polyangiitis (GPA, syn. M. Wegener) often develop an external nose deformity which may have devastating psychological effects. Therefore, reconstruction of nasal deformities by rhinoplasty may become necessary to achieve a normal appearance. 

Nasal Reconstruction in Granulomatosis with Polyangiitis: A Two Decade Review.

It is suggested 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.

Correction of the Saddle Nose Deformity.

Reconstructing the septum is a necessary prerequisite to correcting the contour of the nose, and patients suffering from disfiguring saddle noses can be safely operated on-even those with vasculitic diseases.

ENT manifestations of Granulomatosis with polyangiitis

Clinicians should maintain a high index of suspicion and proceed to a more comprehensive evaluation in cases of imperfect response to treatment or with unexplained atypical findings, as well as determine whether the non- specific local upper aerodigestive symptoms are caused by a specific or a non-specific inflammatory process.

Localized Granulomatous with Polyangiitis (GPA): Varied Clinical Presentations and Update on Treatment

This is a narrative review that provides a comprehensive overview of localized granulomatosis with polyangiitis and current treatment options.

A Case of Granulomatosis with Polyangiitis (GPA) Where a Multicystic Nasal Septal Abscess Aided in the Diagnosis

A 69-year-old male patient presented to the hospital with a chief complaint of nasal obstruction and was diagnosed with vasculitis based on the clinical findings, pathological examination results, and blood test results.

Grafting Techniques in Primary and Revision Rhinoplasty.

Nasal Septal Perforation Closure by "Sandwich Grafts": Technique, Initial Results.

The authors have identified a reliable technique closing septal perforations by an autologous "sandwich graft" layered around a piece of auricular cartilage, covered with temporal fascia, thus emulating the physiological layers of the nasal septum.

Refinements in Saddle Nose Reconstruction

The authors propose their own classification system for saddle nose with one new category and several approaches to deal with this condition in accordance with the level of severity, and strongly advocate major septal reconstruction for most cases of saddle nose.

A glance into the future of anti-neutrophil cytoplasmic antibody-associated vasculitis

This work provides an overview of the current state of the art in AAV literature and suggests bridges for the remaining knowledge gaps and offers potential future directions for the clinical assessment, management, and research in the field toward a more personalized medicine approach.

References

SHOWING 1-10 OF 45 REFERENCES

Repair of saddle nose deformity in Wegener's granulomatosis and ectodermal dysplasia.

By extranasal incisions the nasal dorsum has been successfully reconstructed by transplanting autogenic conchal cartilage and there has been no resorption or displacement of the transplant after twelve months in the case of ectodermal dysplasia, and after 25 years in the patient with Wegener's granulomatosis despite a severe recurrence of this disease.

Restylane--a temporary alternative for saddle nose deformity in nasal Wegener's granulomatosis--how we do it.

[Chronic rhinosinusitis with septal perforation. Differential diagnostic considerations].

The otolaryngologist's role is to initiate, in close cooperation with a rheumatologist, therapy with sulfatrimethoprim, as well as with immunosuppressants if necessary, which helps stabilize the symptomatology and may prevent progressive systemic disease.

Long‐Term Follow‐up of Repair of External Nasal Deformities in Patients With Wegener's Granulomatosis

The study was initiated to determine the efficacy and safety of reconstructing external nasal deformities in patients with Wegener's granulomatosis, characterized histologically by necrotizing granulomas and vasculitis.

Reconstruction of Nasal Deformity in Wegener’s Granulomatosis: Contraindication or Benefit?

External nasal reconstruction for patients affected by WG appears to be safe and effective if the disease is in remission before any operation, and high-dose immune suppression therapy could not be observed in the patients of this series, all of whom were receiving immunosuppressive medication.

Sinonasal Wegener granulomatosis: A single‐institution experience with 120 cases

The objectives of the study were to describe sinonasal symptoms and signs at the time of initial otolaryngologic evaluation, and to review indications and outcomes for rhinologic surgery in WG at the authors' institution.

Reconstruction of short nose deformity using nasolabial flaps pedicled on the infraorbital vessels.

Considerations in the etiology, treatment, and repair of septal perforations.

  • R. Kridel
  • Medicine
    Facial plastic surgery clinics of North America
  • 2004

Head and neck manifestations of Wegener's granulomatosis.

The otorhinolaryngologist plays an important role in early diagnosis of WG, because in up to 95% of the patients initial WG symptoms are observed in the head and neck region, and the majority of patients show nasal or sinunasal involvement.

Nasal surgery in patients with systemic disorders

  • F. SachseW. Stoll
  • Medicine
    GMS current topics in otorhinolaryngology, head and neck surgery
  • 2010
Experiences published so far have shown that autologous cartilage or bone grafts can be used in nasal reconstruction of deformities caused by tuberculosis, leprosy, Wegener’s granulomatosis, sarcoidosis and relapsing polychondritis, which supports the concept that well-established techniques of septorhinoplasty can been used in systemic diseases as well.