Nasal reconstruction with costal cartilage autograft in leprosy

Introduction: Leprosy is a chronic granulomatous infection of the skin, mucosa and peripheral nerves, which often leads to gross distortion of the nasal skeleton and consequent formation of a saddle nose deformity. The destruction of the nasal septum and nasal bones by Mycobacterium leprae and subsequent infection is still seen regularly in endemic areas. The reconstruction of the nose has challenged surgeons for centuries, and different procedures have been proposed and developed.

Objective: To evaluate patients with nasal leprosy sequelae undergoing nasal reconstruction with costal cartilage.

Methods: From January 2005 to January 2010, 20 patients with nasal sequelae of leprosy underwent nasal reconstruction with costal cartilage. Inclusion criteria were: nasal deformity of leprosy and cure for at least 2 years. Exclusion criteria were: lack of clinical conditions for surgery under general anesthesia. Patients were followed postoperatively for at least 1 year. The results were evaluated by comparison of photographs before and after surgery. Complications and patient satisfaction were evaluated.

Results: Age ranged from 34 and 66 years (mean 44.3 years) and they were all male. Evaluating the photographs, 18 patients had results considered excellent/good, one regular and one fair. All patients were satisfied. The most common complications were: nasal synechia (3), nasal obstruction (2), unsightly scar (2), alar base asymmetry (1), dorsal irregularities (1), partial necrosis of the columella (1).

Conclusions: Nasal reconstruction of patients with sequelae of leprosy held through an open approach, using autologous costal cartilage, had a high rate of patient satisfaction, with low complication rate.

Conflict of interest : None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Nasal reconstruction with costal cartilage autograft in leprosy
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