gms | German Medical Science

88th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 27.05.2017, Erfurt

Article

Send article

Saddle nose deformity and septal perforation in granulomatosis with polyangiitis – a systematic literature review

Meeting Abstract

Search Medline for

  • Sonja Loose - Charité Campus Benjamin Franklin c/o Dr. Andreas Albers, Berlin
  • corresponding author Annekatrin Coordes - Charité Campus Benjamin Franklin, Berlin
  • Veit Hofmann - Charité Campus Benjamin Franklin, Berlin
  • Andreas Albers - Charité Campus Benjamin Franklin, Berlin

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 88. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Erfurt, 24.-27.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. Doc17hno538

doi: 10.3205/17hno538, urn:nbn:de:0183-17hno5386

Published: April 13, 2017

© 2017 Loose et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Introduction: A developing external nose deformity severely affects the appearance of granulomatosis with polyangiitis (GPA) patients, often with devastating psychological effects. The aim of this systematic review was to investigate the efficacy and safety of surgical reconstruction in external nasal deformities and septal perforation in GPA patients.

Methods: A systematic literature search was performed for scientific articles archived in the MEDLINE-Database up to June 10th, 2016, describing management of cases in GPA patients with saddle nose deformity and/or septal perforation.

Results: Eleven of 614 publications met the criteria for this analysis including 41 GPA patients undergoing external nasal reconstruction and/or septal reconstruction with a median follow-up of 2.6 years. Overall, saddle nose reconstruction in GPA patients is safe even if an increased rate of revision surgery has to be expected. Most implanted grafts were autografts of calvarial bone or costal cartilage. For septal perforation reconstruction, few studies were available. Therefore, on current knowledge, surgical outcomes cannot be deduced from the data. All included GPA patients had minimal or no local disease at the time of reconstructive surgery. Therefore, the relationship between disease activity and its impact on surgical outcomes remains unanswered.

Conclusion: This study systematically reviews the efficacy and safety of surgical reconstruction of external nasal deformities in GPA patients for the first time. Saddle nose reconstruction in GPA patients with minimal or no local disease is a safe procedure despite an increased rate of revision surgery. Further research is required regarding the impact of immune-modulating therapy, long-term outcomes and functional outcomes.

Der Erstautor gibt keinen Interessenkonflikt an.