Review of tactics of surgical treatment of acquired defects of anatomical structures of external nose in children

Elimination of defects of the anatomical structures of the external nose is the most complex area of reconstructive surgery, from simple suturing of a small defect and adequate matching of the wound edges to the use of revascularized flaps from distant parts of the body. Difficulties arise due to the special anatomy of this area and the limited number of local and regional flaps. The article provides an overview of treatment methods based on the experience of Russian and foreign surgeons, as well as a series of our own observations. OBJECTIVE: To analyze our own clinical cases of acquired defects of the anatomical structures of the external nose (features of surgical treatment) and compare them with the data of Russian and foreign literature. MATERIAL AND METHODS: A retrospective review of case histories with the diagnosis of «Acquired defect of the external nose» was conducted from 2015 to June 2025 in the Pediatric Otolaryngology Department of the Federal State Budgetary Institution of Higher Education NMITSO FMBA of Russia, the Russian Children's Clinical Hospital - a branch of the Federal State Autonomous Educational Institution of Higher Education RNIMU named after N.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. Complaints, anamnesis data, results of endoscopic examination and efficiency of the performed surgical treatment were analyzed. RESULT: Over the last 10 years, 16 patients with the diagnosis of «Acquired defects of the external nose» were treated in the pediatric otolaryngology departments of the Federal State Budgetary Institution of Higher Education N.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. The acquired defect of the external nose was located on the wings of the nose in 1 patient, the dorsum of the external nose - in 3 patients, the columella of the nose - in 7 patients, cicatricial obliterations of the vestibule of the nasal cavity - in 2 patients, combined defects of the external nose - in 3 patients. All patients underwent surgical treatment. A combined treatment method was used in all patients. No relapses were observed in any of the patients after surgical treatment using the methods we proposed for a period of 6 months to 5 years (3 years on average). CONCLUSION: The development of an algorithm for reconstruction and a surgical approach to the treatment of acquired defects of the external nose in children ensures not only an optimal functional result, but also an aesthetic one, and helps to anticipate problems that can be avoided through careful preoperative planning.