Total nasal skeletal reconstruction disfigured by granulomatosis with polyangitis (wegener granulomatosis).
BACKGROUND
Nasal deformity is a common disorder in Wegener granulomatosis, which is produced by polyangitis of medium-sized vessels. This process may cause necrosis and destruction of the nasal mucosa and osteocartilaginous framework. At this time, there is a lack of published data on nasal deformities associated with Wegener granulomatosis.


METHODS
We present a 53-year-old woman with completely necrotized nasal lining and osteocartilage. The patient had a history of granulomatosis with polyangitis that was currently in remission. We reconstructed the patient's nose with fifth and sixth rib cartilages over 3 successive surgeries over a 2-year period.


RESULTS
During the 3-year follow-up period, neither infection nor significant cartilage graft resorption was observed, and the aesthetic result was acceptable both to the patient and her physicians.


CONCLUSIONS
In spite of contamination to the nasal lining and immune-compromising medications, nasal reconstruction is usually successful when considering these factors. Access to strong and abundant fifth or sixth rib cartilage presents an opportunity to reconstruct nasal destruction due to iatrogenic or autoimmune processes.
St. Fatima Hospital and Burn Research Center, Iran University of Medical Sciences, Tehran, Iran; Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; St. Fatima Hospital, Tehran University of Medical Sciences, Tehran, Iran; Kowsar Laboratory, Tehran, Iran; and Tehran University of Medical Sciences, Tehran, Iran.
Farhad
F
Hafezi
St. Fatima Hospital and Burn Research Center, Iran University of Medical Sciences, Tehran, Iran; Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; St. Fatima Hospital, Tehran University of Medical Sciences, Tehran, Iran; Kowsar Laboratory, Tehran, Iran; and Tehran University of Medical Sciences, Tehran, Iran.
Bijan
B
Naghibzadeh
St. Fatima Hospital and Burn Research Center, Iran University of Medical Sciences, Tehran, Iran; Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; St. Fatima Hospital, Tehran University of Medical Sciences, Tehran, Iran; Kowsar Laboratory, Tehran, Iran; and Tehran University of Medical Sciences, Tehran, Iran.
Abbas Kazemi
AK
Ashtiani
St. Fatima Hospital and Burn Research Center, Iran University of Medical Sciences, Tehran, Iran; Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; St. Fatima Hospital, Tehran University of Medical Sciences, Tehran, Iran; Kowsar Laboratory, Tehran, Iran; and Tehran University of Medical Sciences, Tehran, Iran.
Amir Hossein
AH
Nouhi
St. Fatima Hospital and Burn Research Center, Iran University of Medical Sciences, Tehran, Iran; Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; St. Fatima Hospital, Tehran University of Medical Sciences, Tehran, Iran; Kowsar Laboratory, Tehran, Iran; and Tehran University of Medical Sciences, Tehran, Iran.
Ghazal
G
Naghibzadeh