In recent years, the widespread adoption of endoscopic sinus surgery (ESS) has increased the use of minimally invasive procedures for sinonasal tumors. However, extensive mucosal defects and scar contracture after tumor resection can result in external nasal deformities. To date, no studies have focused on reconstructive surgery for external nasal deformities following ESS. We describe a case of saddle nose deformity after endoscopic resection of ethmoid sinus carcinoma. Reconstruction was performed using a costal cartilage graft, inserted from the nasal root to the tip and reinforced with a pericranial flap. Two years postoperatively, mild deviation due to cartilage warping and mucosal contracture was observed, but the external contour remained stable. When performing nasal reconstruction after ESS, careful consideration should be given to mucosal scar contracture, thinning of the mucosa, and the risk of graft exposure. The pericranial flap, with reliable blood supply and flexibility, proved useful for preventing graft exposure.
Kanehara et al. (Thu,) studied this question.