title: The role of maxillary osteotomy in the treatment of arhinia.
abstract: OBJECTIVE
  Arhinia is a very rare malformation, and only 41 cases are described in the literature. Given its rarity, there is no standardized surgical protocol. This article describes our preferred treatment, which underlines the importance of maxillary osteotomy for obtaining satisfactory results.
  
  
  METHODS
  We observed 3 girls with arhinia, 2 of whom were treated by a 2-step surgical protocol. During the first phase, the patients underwent maxillary osteotomy with the creation of a new epithelium-lined nasal cavity. A skin expander was also placed in the forehead. During the second step, an external nose was created in both patients from the expanded forehead flap with local perinasal flaps and costochondral grafts.
  
  
  RESULTS
  Both reconstructions were viable and esthetically acceptable. No internal nose restenosis was observed.
  
  
  CONCLUSIONS
  On the basis of our experience, maxillary osteotomy should be considered part of an integrated approach in treating arhinia.
authors.affiliation: Department of Maxillo-Facial Surgery, University of Milan, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Brusati
authors.forename: Giacomo
authors.initials: G
authors.lastname: Colletti
mesh_terms: D001860:Bone Plates; D002356:Cartilage / Q000637:transplantation; D002648:Child; D004954:Esthetics; D005260:Female; D006801:Humans; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery*; D009296:Nasal Cavity / Q000002:abnormalities / Q000601:surgery; D009666:Nose / Q000002:abnormalities*; D019340:Osteotomy, Le Fort / Q000379:methods*; D010256:Paranasal Sinuses / Q000002:abnormalities; D012225:Rhinoplasty / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D015625:Tissue Expansion Devices; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome