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Heminasal Agenesis: A Reconstructive Challenge

Fisher, Mark BA; Zelken, Jonathan MD; Redett, Richard J. MD

Journal of Craniofacial Surgery: May 2014 - Volume 25 - Issue 3 - p e239–e241
doi: 10.1097/SCS.0000000000000542
Brief Clinical Studies
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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.

Received October 4, 2013.

Accepted for publication November 13, 2013.

Address correspondence and reprint requests to Richard J. Redett, MD, Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Bloomberg 7314B, 1800 Orleans St, Baltimore, MD 21287; E-mail: rredett1@jhmi.edu

The authors report no conflicts of interest.

© 2014 by Mutaz B. Habal, MD.