Partial Absence of Lower Lateral Cartilage

Introduction: Congenital anomalies of the nose are rare and occur in 1 of 20,000 to 1 of 40,000 newborns. Congenital absence as an isolated deformity of the lower lateral cartilage (LLC) is extremely rare with only two cases described in the current literature. In one of the described cases, there was a total absence of the LLC, whereas in the other case, the absence was only partial.

Objectives: This study aims to report a case of partial absence of LLC.

Resumed Report: A 23-year-old male patient presented to the ENT clinic, complaining of chronic alternating nasal obstruction and no significant improvement after medical treatment. The patient’s medical history was unremarkable except for a history of atopy. During inspiration, there was partial collapse of the right internal valve, indicating valve insufficiency. He also presented with an esthetical complaint of asymmetric tip and a dorsal nasal hump. Rhinoscopy revealed a nonobstructive septal deviation and hypertrophy of inferior turbinates. Surgery consisted of hump reduction, lateral crura reconstruction with septal cartilage, tip refinement with domal sutures, and camouflage graft. Columellar strut was placed to structure the tip.

Conclusion: The pathogenesis of the congenital absence of nasal cartilages as an isolated entity is unknown. Embryogenic development may explain this condition as local factors, such as a teratogen, vascular accident, and pressure by the surrounding tissue may impair the regular development of nasal components. Continued developmental studies are crucial for eventual understanding of the complex embryology and factors related to the development of those rare anomalies.