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J Cosmet Med 2021; 5(2): 86-89

Published online December 31, 2021

https://doi.org/10.25056/JCM.2021.5.2.86

A case of alar stenosis: single-staged alar reconstruction

Ji-Woong Cho, MD1 , Hye Jeen Kim, MD1 , Do-Yoon Jeong, MD1 , Ibrahim AlQuniabut, MD2 , Ji Yun Choi, MD, PhD1

1Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea
2Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Buraydah, Kingdom of Saudi Arabia

Correspondence to :
Ji Yun Choi
E-mail: happyent@naver.com

Received: November 25, 2021; Revised: December 23, 2021; Accepted: December 23, 2021

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

The ala is a cosmetically and functionally critical part of the nose, with unique esthetic and anatomical characteristics. Herein, we report our experience of alar reconstruction. A 56-year-old female was diagnosed with intranasal mucosal melanoma and was treated by surgical excision and radiotherapy. She developed left nostril deformity after the completion of oncological treatment. She underwent single-staged alar reconstruction surgery using alar rotational and turning-in flaps with septal and conchal cartilage reconstruction of the ala and lower lateral cartilage. A defect of the ala as a result of cancer excision or trauma is a challenging entity in facial reconstruction. In addition, radiotherapy is a burden for major reconstructive flaps because of defective healing. Hence, singlestaged local flaps with septal and conchal cartilage reconstruction results in good outcome and fewer complications.

Keywords: external nasal valve, nasal reconstruction, nostril, nostril reconstruction, rhinoplasty, stenosis of nostril

Fig. 1.Preoperative photo. Physical examination of the ala shows scar tissue over the left alar skin and superior vestibular surface, with the alar rim retracted superiorly and posteriorly due to the contracture effect. The nostril is stenotic and narrow with soft triangle blunting, pulling the tip of the nose and columella to the left side. An abnormal curvature of the alar wall is observed, indicating a misshaped lower lateral cartilage.
  1. Burget GC. Aesthetic reconstruction of the tip of the nose. Dermatol Surg 1995;21:419-29.
    Pubmed CrossRef
  2. Sherris DA, Larrabee WF Jr. Principles of facial reconstruction: a subunit approach to cutaneous repair. 2nd ed. New York, NY: Thieme; 2009. p. 102-60.
  3. Bloom JD, Ransom ER, Miller CJ. Reconstruction of alar defects. Facial Plast Surg Clin North Am 2011;19:63-83.
    Pubmed CrossRef
  4. Daines SM, Hamilton GS 3rd, Mobley SR. A graded approach to repairing the stenotic nasal vestibule. Arch Facial Plast Surg 2010;12:332-8.
    Pubmed CrossRef
  5. Kim MS, Choi JY. Surgical reconstruction of nasal alar deformities. J Rhinol 2017;24:65-73.
    CrossRef
  6. Neltner SA, Papa CA, Ramsey ML, Marks VJ. Alar rotation flap for small defects of the ala. Dermatol Surg 2000;26:543-6.
    Pubmed CrossRef
  7. Yellin SA, Nugent A. Melolabial flaps for nasal reconstruction. Facial Plast Surg Clin North Am 2011;19:123-39.
    Pubmed CrossRef

Article

Case Report

J Cosmet Med 2021; 5(2): 86-89

Published online December 31, 2021 https://doi.org/10.25056/JCM.2021.5.2.86

Copyright © Korean Society of Korean Cosmetic Surgery.

A case of alar stenosis: single-staged alar reconstruction

Ji-Woong Cho, MD1 , Hye Jeen Kim, MD1 , Do-Yoon Jeong, MD1 , Ibrahim AlQuniabut, MD2 , Ji Yun Choi, MD, PhD1

1Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea
2Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Buraydah, Kingdom of Saudi Arabia

Correspondence to:Ji Yun Choi
E-mail: happyent@naver.com

Received: November 25, 2021; Revised: December 23, 2021; Accepted: December 23, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The ala is a cosmetically and functionally critical part of the nose, with unique esthetic and anatomical characteristics. Herein, we report our experience of alar reconstruction. A 56-year-old female was diagnosed with intranasal mucosal melanoma and was treated by surgical excision and radiotherapy. She developed left nostril deformity after the completion of oncological treatment. She underwent single-staged alar reconstruction surgery using alar rotational and turning-in flaps with septal and conchal cartilage reconstruction of the ala and lower lateral cartilage. A defect of the ala as a result of cancer excision or trauma is a challenging entity in facial reconstruction. In addition, radiotherapy is a burden for major reconstructive flaps because of defective healing. Hence, singlestaged local flaps with septal and conchal cartilage reconstruction results in good outcome and fewer complications.

Keywords: external nasal valve, nasal reconstruction, nostril, nostril reconstruction, rhinoplasty, stenosis of nostril

Fig 1.

Figure 1.Preoperative photo. Physical examination of the ala shows scar tissue over the left alar skin and superior vestibular surface, with the alar rim retracted superiorly and posteriorly due to the contracture effect. The nostril is stenotic and narrow with soft triangle blunting, pulling the tip of the nose and columella to the left side. An abnormal curvature of the alar wall is observed, indicating a misshaped lower lateral cartilage.
Journal of Cosmetic Medicine 2021; 5: 86-89https://doi.org/10.25056/JCM.2021.5.2.86

References

  1. Burget GC. Aesthetic reconstruction of the tip of the nose. Dermatol Surg 1995;21:419-29.
    Pubmed CrossRef
  2. Sherris DA, Larrabee WF Jr. Principles of facial reconstruction: a subunit approach to cutaneous repair. 2nd ed. New York, NY: Thieme; 2009. p. 102-60.
  3. Bloom JD, Ransom ER, Miller CJ. Reconstruction of alar defects. Facial Plast Surg Clin North Am 2011;19:63-83.
    Pubmed CrossRef
  4. Daines SM, Hamilton GS 3rd, Mobley SR. A graded approach to repairing the stenotic nasal vestibule. Arch Facial Plast Surg 2010;12:332-8.
    Pubmed CrossRef
  5. Kim MS, Choi JY. Surgical reconstruction of nasal alar deformities. J Rhinol 2017;24:65-73.
    CrossRef
  6. Neltner SA, Papa CA, Ramsey ML, Marks VJ. Alar rotation flap for small defects of the ala. Dermatol Surg 2000;26:543-6.
    Pubmed CrossRef
  7. Yellin SA, Nugent A. Melolabial flaps for nasal reconstruction. Facial Plast Surg Clin North Am 2011;19:123-39.
    Pubmed CrossRef

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