The role of maxillary osteotomy in the treatment of arhinia

Purpose: Arhinia is a very rare malformation, and only 41 cases are described in the literature. Given its rarity, there is no standardized surgical protocol. This article describes our preferred treatment, which underlines the importance of maxillary osteotomy for obtaining satisfactory results. Methods: We observed 3 girls with arhinia, 2 of whom were treated by a 2-step surgical protocol. During the first phase, the patients underwent maxillary osteotomy with the creation of a new epithelium-lined nasal cavity. A skin expander was also placed in the forehead. During the second step, an external nose was created in both patients from the expanded forehead flap with local perinasal flaps and costochondral grafts. Results: Both reconstructions were viable and esthetically acceptable. No internal nose restenosis was observed. Conclusions: On the basis of our experience, maxillary osteotomy should be considered part of an integrated approach in treating arhinia.