title: Depletion of the nasal reserve after a mole excision.
abstract: The authors present an original case report to warn of a possible severe functional complication that might follow a simple facial skin procedure. A 55-year-old woman underwent excision of a mole along the alar-facial groove, which seemingly healed without immediate complications. Ultimately the patient reported an ipsilateral nasal obstruction 2 months postoperatively. Intranasal inspection and a computed tomography scan revealed a severe septum deviation that had been previously clinically unapparent. The authors argue that the skin-scarring process progressively counterbalanced the action of the levator labii superioris alaeque nasi muscle fascicle to the nostril. Such an action had been compensating for a subtotally compromised nasal air flow from a preexisting severe septal deviation. In this context, skin scarring was enough to impair a minimal residual nasal respiratory reserve. The authors therefore advise performing an internal nasal inspection at all times prior to any sort of skin surgery around the alar-facial groove. This will allow detection of any subclinical functionally compensated preexisting septal deviation or any other intranasal obstruction that could manifest at a later stage.
authors.forename: Silvia
authors.initials: S
authors.lastname: Scevola
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nicoletti
authors.forename: Claudio
authors.initials: C
authors.lastname: Albizzati
authors.forename: Angela
authors.initials: A
authors.lastname: Faga
mesh_terms: D002921:Cicatrix / Q000209:etiology; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects; D004724:Endoscopy / Q000379:methods; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology*; D009300:Nasal Septum / Q000473:pathology; D018330:Nevus, Intradermal / Q000601:surgery*; D009668:Nose Diseases / Q000150:complications; D011183:Postoperative Complications; D012878:Skin Neoplasms / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods