Heminasal agenesis: a reconstructive challenge.
Heminasal agenesis is a rare congenital malformation often associated with deformities of the eyes and lacrimal system, midface, and proboscis lateralis. Reconstruction is especially challenging because of missing lining, cartilage, and skin. We present a case of heminasal agenesis in a 5-year-old girl with concomitant hypertelorism, coloboma of the eyelids, and maxillary hypoplasia. The patient underwent facial bipartition for hypertelorism correction and cantilever bone graft. A forehead flap was designed using an anaplastic model from the patient's twin sister. Cartilage harvested from the conchal bowl and rib provided alar and dorsal support. Reconstructive goals, timing, and options are discussed.
From the Departments of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Mark
M
Fisher
Jonathan
J
Zelken
Richard J
RJ
Redett
D002675:Child, Preschool; D003103:Coloboma / Q000601:surgery; D005143:Eyelids / Q000002:abnormalities*; D005260:Female; D006801:Humans; D006972:Hypertelorism / Q000601:surgery; D008437:Maxilla / Q000002:abnormalities*; D019767:Maxillofacial Abnormalities / Q000601:surgery*; D009666:Nose / Q000002:abnormalities*; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome