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Case Reports
. 2018 Summer;18(2):176-179.
doi: 10.31486/toj.17.0052.

Resection of Nasal Glial Heterotopia Using a Nasal Subunit Approach

Michael T Friel  1 , Roberto L Flores  2
Affiliations
Case Reports

Resection of Nasal Glial Heterotopia Using a Nasal Subunit Approach

Michael T Friel et al. Ochsner J. 2018 Summer.

Abstract

Background: In the subunit principle of nasal reconstruction, the valleys and low ridges of the nose are designated as topographic subunits. Surgical scars can be located at the borders of subunits to hide their appearance.

Case report: A 30-month-old female presented with an obstructing nasal glial heterotopia (nasal glioma). Using the nasal subunit approach, the mass was exposed using an incision along the subunit borders of the nose. The nasal glioma was completely resected, and the internal nasal valve and the deformed lower lateral cartilages were reconstructed through the subunit approach access incision. The final scar was placed along the subunit borders of the nose. At 6-month follow-up, the patient demonstrated no airway obstruction, adequate nasal contour, and an esthetic nasal scar.

Conclusion: The subunit approach for a large, obstructing nasal glial heterotopia allows direct exposure for tumor resection, framework reconstruction, placement of the incision in an esthetic location, and excision of the expanded skin for recontouring of the skin envelope.

Keywords: Glioma; nasal obstruction; surgery–plastic.

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Figures

Figure 1.
Figure 1.. Preoperative anteroposterior (A), lateral (B), midface (C), and worm's eye (D) views of the patient show the large, bulbous mass obstructing the right nostril and distorting the upper lateral and lower lateral cartilages.
Figure 2.
Figure 2.. Operative marking and demonstration of nasal obstruction in the anteroposterior (A) and worm's eye (B) views. The marking is placed to allow for the final scar to be located between nasal subunits.
Figure 3.
Figure 3.. Nasal glial heterotopia dissected prior to excision. The mass measured 2.5 × 1.5 × 2.0 cm.
Figure 4.
Figure 4.. Postoperative anteroposterior (A), oblique (B), and worms-eye (C) views at 6-month follow-up show an esthetically acceptable result with complete resolution of preoperative symptoms.
See this image and copyright information in PMC

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