Nasal Framework Osteotomy: An Innovative Approach to Manage an Extremely Long Nose With Meningoencephalocele

Behnam Bohluli, Elizabeth Consky, Farzin Sarkarat, Hesam Abdolhoseinpour
Journal of Oral and Maxillofacial Surgery 2019 February 12
Nasal encephalocele is an uncommon congenital deformity in which the intracranial soft tissue components herniate through the skull base into the nasal cavity. Nasal encephaloceles can form large extracranial masses that necessitate early neurosurgical intervention. They also can cause deformation of the nasal bridge, causing elongation of the nose or severe orbital deformities. The conventional approach requires a wide and complicated intracranial access. This report describes the nasal framework osteotomy, an extracranial approach through the nasal bridge that allows visualization and reflection of the herniated tissue. A complete osteotomy is performed around the nose, followed by total mobilization and lifting of the nasal framework. This is a relatively simple extracranial approach that results in minimal scarring, achieving the neurosurgical and esthetic goals of care.

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