Autoimmune Nasal Destruction and Deformity, Total Reconstruction, Case Report

Nasal deformity is a common disorder in Wegener granulomatosis (WG)، which is produced by polyangitis of medium-sized vessels. This process may cause necrosis and destruction of the nasal mucosa and osteocartilagenous framework. At this time، there is a lack of published data on nasal deformities associated with WG. We present a 53-year-old female 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 cartilage through a minimal 2 cm incision over 3 successive surgeries over a 2-year period. During the three-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. 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.