NASAL VESTIBULAR STENOSIS: PRESENTATION OF 5 CASES

¹Yüzüncüyıl Üniversitesi Tıp Fakültesi, KBB Bölümü, Van, Türkiye
²Ankara Asker Hastanesi, KBB Bölümü, Ankara, Türkiye Nasal vestibular stenosis (NVS) is obstructive constriction of nasal vestibulum by fibrous and granulomatous growths originated from its muco-cutaneous lining or by deformities of surrounding cartilages. Traumas and inflammations constitute its most common etiologies , followed by congenital and iatrogenic causes.Various surgical techniques have been implemented in NVS correction, that is challenging and carries a high recurrence rate.The objective of this study is to demonstrate that; different methods can be employed depending on the type and extent of the stenosis as well as accompanying deformities in NVS surgery, minimizing surgical trauma is prudent and postoperative wound care is as effective as the surgical technique for favorable outcome.We herewith present 5 cases of NVS who were operated in 1998-2005 with various surgical methods with the resultant vestibular patency and in some of the cases cosmetic improvements. Only one of the cases had to be re-operated. In 2 of the patients, external approach was used as 4 operations were carried out with internal approach. In 3 of the operations, stenotic rings were totally resected and surgical defects were grafted, whereas in the remaining 3 operations submucous/cubcutanous resection of the stenotic fibrous tissue is complemented by resurfacing vestibulum with local skin and mucosa. Soft silicon stents were placed in reconstructed vestibules and kept in place for 2-4 weeks postoperatively.The experience we have acquired through these operations indicated that, limiting surgical trauma, utilizing local flaps when possible and good wound care minimize potential recurrences in NVS surgery. Keywords : Nasal vestibulum, stenosis, anterior nares, nasal apertura, nasal airway, corrective surgery