Nasal reconstruction in children

The nose represents the center of the face. The nasal shape changes with the progression from infancy to adulthood. In newborns, the main supporting structure of the nose is the dorsal septal cartilage; it is the facial growth center. The loss of septal cartilage at different ages leads to various facial syndromes involving the nose, maxilla, and orbita. Therefore, every surgical treatment can compromise not only the nasal growth but also the growth of the whole face. Childhood trauma or a malformation of the nose can also cause enormous functional impairments similar to those caused by surgical treatments. Our contribution represents different aspects of nasal deformities and their treatment. An individual concept is indispensable to reach the best compromise in all cases. The postulate of an early treatment gives priority to physical and mental damage control. The late therapy concept uses the inimitable potential of the growth of different tissues needed for a septoplasty and should be protected from iatrogenic impairment. We recommend a first-line pediatric nasal reconstruction, an attentive follow-up, and finally, a secondary nasal reconstruction in the adult patient if required for achieving normalcy.