(A415) Extended open rhinoplasty approach for excision and reconstruction of midline nasal mass: a case series

Introduction: We report a series of three cases of midline nasal masses excised and reconstructed through an extended endoscopic-assisted open rhinoplasty approach.

Methods: In each of the three cases, an extended open rhinoplasty approach was utilized for resection of midline nasal masses and concurrent reconstruction of the nasal defect. Visualization and access are enhanced with the use of nasal endoscopy and sinus surgery instruments. Resection was performed and open roof deformity was encountered in each case. Open roof deformity reconstruction was performed using an acellular dermal matrix in two patients and an autologous graft in one patient.

Results: The procedures were successful, with aesthetically pleasing results and without complications. The patients presented for follow-up with minimal edema and tenderness of the nose and no evidence of recurrence of the lesions.

Conclusions: An extended rhinoplasty approach should be considered for congenital nasal masses and other benign nasal lesions. It allows an aesthetically pleasing scarring and provides an opportunity to reconstruct the defect simultaneously. Limitations of access and visualization are addressed with the concurrent use of endoscopes and sinus instruments. Concurrent rhinoplasty proves optimal for direct visualization of the nasal roof deformity post-resection of the midline masses. Acellular dermal matrix and autologous materials can be in nasal reconstruction. This approach provides favorable aesthetic and functional outcomes upon follow-up.