Rhinoplasty in a Patient with Collapsed Nose Secondary to Granulomatosis with Polyangiitis: A Case Report

Wegener's granulomatosis or Granulomatosis with polyangiitis (GPA) is aa necrotizing vasculitis of small to medium size blood vessels. It may present as limited forms, involving one or two ELK (E-ear, nose and throat involvement; L-lung involvement; K-kidney) areas, or a severe, generalized form. Involving nasal mucosa in GPA leads to a vicious cycle of continuous inflammation and healing process resulting granulation tissue formation and it leads to soft tissue contracture. this cycle of inflammation and healing leads to weakened nasal septum cartilages secondarily to the inflammatory process and results in septal perforation. As septal perforation enlarges it can cause weakening of nasal dorsum support and can cause 'saddle nose deformity'. Rhinoplasty for reconstruction of nasal deformity should be attempted if stable remission was achieved. Use of cartilage grafts and the timing of surgery plays a key role in aesthetic improvement of deformed nasal architecture after rhinoplasty in patients with GPA.