International Journal of Surgical Wound Care
Online ISSN : 2435-2128
Case Reports
Reconstruction of Severe Nasal Deformity Following an Infantile Hemangioma
A Case Report
Sayaka HoshinoTadashi NomuraAya MoriwakiYasuko HasegawaHiroshi KitagawaHiroto Terashi
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2022 Volume 3 Issue 4 Pages 138-143


Infantile hemangiomas are benign vascular tumors that may require treatment if they cause significant disfigurement or functional disorders such as airway obstruction. Aggressive treatment, such as medication or surgery, is preferred, especially for infantile hemangiomas of the outer nose, which may be associated with tissue defects or deformities. In this case, we performed early reconstruction of an ulcerated extranasal infantile hemangioma based on defective tissues. Although the lesion regressed after propranolol therapy, the septal cartilage and major alar cartilage were partially damaged and the supporting tissue was disrupted. The nasal mucosa and skin were scarred. When the child reached 5 years and 4 months of age, we grafted a rib cartilage as supportive tissue and a free forearm flap as the nasal cavity lining. A median forehead flap surgery was performed for the skin defect in two stages, and the external nasal morphology improved moderately. External nasal reconstruction in children with infantile hemangiomas require reconstruction based on the defective tissue, as in adults. However, the optimal timing of external nasal reconstruction in children remains controversial, and further investigations are required.

Second surgery at the age of 5 years and 9 months. Fullsize Image
(A) The rib cartilage is grafted as the alar margin graft, columella strut, and cap graft. (B) Grafted rib cartilage graft and raised median forehead flap. (C) The nose is covered with the median forehead flap.
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© Japan Society for Surgical Wound Care 2022
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