Correction of Saddle Nose Deformity in Wegener's Granulomatosis

ABSTRACT

The nasal manifestations of the Wegener's granulomatosis commonly results in destruction of the cartilaginous support of the nose and a severe saddle nose deformity. It is so difficult to correct the saddle nose deformity because surgeons have fear about relapse of the Wegener's granulomatosis and cannot use the septal cartilage as a donor site. However we reconstructed the deformity with chondro-osseous rib graft successfully. A 49-year-old woman had a saddle nose deformity after resecting Wagener's granulomatosis, and suffered from not only aesthetic problem but also dyspnea and nasal airway obstruction while physical exercise. She underwent a rhinoplasty with rib graft. The correction came out to be successful and the nasal airway complaint was resolved. She had a recurrence of Wegener's granulomatosis at postoperative 6 months and was admitted for medical treatment of the inflammation at the nasal septum. The follow-up computed tomographic image study revealed good maintenance of the graft. Saddle nose deformity that arises from Wagener's granulomatosis should be reconstructed with chondro-osseous rib graft. Even though the disease might recur, influence to the grafted cartilage is minimal. Active treatment with plastic surgery is thought to be no problem for reconstruction.