Total nasal skeletal reconstruction disfigured by granulomatosis with polyangitis (wegener granulomatosis).

Described in 1936 by German pathologist Friedrich Wegener, granulomatosis with polyangitis is the most common upper airway granulomatosis disease. At this time, there is a paucity of literature concerning nasal reconstruction in patients with Wegener granulomatosis (WG).1–3 Surgeons are reluctant to perform nasal reconstruction in these patients for several reasons, including fear of local and systemic flare up, fear of contaminated nasal mucosa, the possibility of redestruction and infection of grafted structures, and use of prolonged anti-inflammatory medications.1 Severe nasal disfigurement may have serious psychological consequences on a victim’s behavior. A high rate of remission and disease control of WG with modern medical therapy has opened the door for reconstructive intervention into this condition. Here, we present the results of a woman with a history of WG and completely necrotized nasal lining and osteocartilage who underwent successful nasal reconstruction with rib cartilage.