Simultaneous and symmetrical reconstruction of heminose and restoration of nasal airway in congenital absence of heminose

Congenital absence of heminose is an extremely rare anomaly. Reconstruction of full thickness defects of the nose requires lining, support and cover. Reconstruction of congenital absence of heminose has an additional requirement of reconstruction of the nasal airway. Simultaneous reconstruction of the heminose and internal nasal passage has not been reported earlier. In a case of congenital absence of heminose, reconstruction of the heminose and internal nasal passage was done simultaneously by using expanded forehead tissue and a nasolabial flap. The nasolabial flap is robust and supports the alar margin without any need of cartilage support. The bulk of subcutaneous tissue it carries lies on the outerside of nostril and, therefore, it does not obstruct the nasal opening. This was covered by expanded forehead tissue, which got thinned out due to tissue expansion, thus achieving symmetry with other half of nose. Skin of the nasolabial flap lines nasal passage thereby avoiding the need of splintage of nasal airway which is required if nostril is lined by split skin graft.