Manuscript Title:An aesthetic nasal conformer – a case report
Corresponding author
GunjanSingh Aswal MDS
Assistant lecturer
Department of restorative dentistry
Libyan international medical university
Benghazi, Libya
Email id – aswallibya@gmail.com
Mob no +91 9980744211
Second author
Dr Shashi Kiran Mohan Ram MDS
Senior lecturer
Department of oral medicine and radiology
Dayanadasagarcollege of dental sciences
Bangalore
Email id – drshashikiranm@yahoo.com
Third author
Dr Selvakumar MDS
Abstract
Nasal contractures due to burns can cause collapse of the nasal aperture, leading to airway obstruction, correction of which requires surgical and prosthetic intervention. Prosthetically, a nasal conformer is the treatment of choice. Unfortunately even a well made nasal conformer has the disadvantage of being aesthetically unappealing and requires a retentive aid. An implant as a retentive aid is not always the option because of its high cost, rendering it unaffordable. Hence the purpose of this article is to describe the fabrication and use of a simple aesthetic nasal conformer to prevent the contracture of nasal aperture and maintain airway patency, thereby overcoming the demerits of a conventional nasal conformer. Introduction The facial region is a prime determinant of the physical attractiveness of individuals in their own eyes as well as in the eyes of others. The face serves as an important source of verbal & non-verbal communication that helps to regulate normal social interactions. Hence the face is said to be our window to the world1. Defects of the nose may result from congenital abnormalities, burn, trauma, tumor excision and complications of cosmetic or airway enhancement procedures2. In cases of acid burns, the damage to the biological structures depends on the concentration of the acid and the period of time before the acid is thoroughly washed off with water or neutralized with a neutralizing agent. The acid can rapidly eat way the skin, fat and fascia beneath the skin and in some cases even the underlying bone may be destroyed. It may also cause contractures resulting in shrunken nostrils due to destroyed cartilage and post operative fibrosis/ scarring3. Since the nose is a prominent feature of the face, and nasal deformities present complicated reconstruction problems, the correction or rehabilitation of this structure assumes great importance4. The treatment of such defects would require surgical and/or Prosthetic intervention to improve both form and function. Intranasal splints, stents like nasal conformer maintain airway patency, maintain tissue position, reduce tissue contracture after surgery or support mobile tissue in the construction and retention of facial prostheses5.6. Unfortunately, even a well made nasal conformer is not aesthetic and ill fitting due to lack of retentive aides. To overcome this, implants may be used as retentive aids7. But implants are expensive and unaffordable by most patients. Hence, the purpose of this article is to describe the fabrication and use of a simple, aesthetic, affordable nasal conformer to prevent the contracture of nasal aperture and maintain airway patency. Case report A 12 yr old patient with a history of acid burn on the right side of the face reported to the clinic (fig 1a).She presented with skin discoloration and scarring on the right side of the …show more content…
She reported that the incident occurred about 2 years ago when acid (sulphuric acid) used for checking the purity of milk in the milk centres splashed on the right side of her face. She was rushed to the nearby hospital where she received first aid. It included flushing of the damaged area with water and application of solution of bicarbonate of soda. As a definitive treatment, over a period of two years skin grafts were placed followed by coconut oil massage, steroid therapy, germ cell infiltration, laser therapy to tone the skin colour. However she complained of gradual constriction of her right nasal aperture and difficulty in breathing because of the closure.
As per our treatment plan, a nasal conformer was planned for the patient. She readily agreed for the same but requested that it be aesthetically acceptable and easy to wear. Hence it was decided to fabricate a nasal conformer using acrylic which is characterized to match the patient’s skin tone. A compressible nose stud, an ornament commonly worn by women in the Indian Sub-continent was chosen as a retentive aid for the nasal conformer making it more aesthetically appealing. The procedure is as
Corresponding author
GunjanSingh Aswal MDS
Assistant lecturer
Department of restorative dentistry
Libyan international medical university
Benghazi, Libya
Email id – aswallibya@gmail.com
Mob no +91 9980744211
Second author
Dr Shashi Kiran Mohan Ram MDS
Senior lecturer
Department of oral medicine and radiology
Dayanadasagarcollege of dental sciences
Bangalore
Email id – drshashikiranm@yahoo.com
Third author
Dr Selvakumar MDS
Abstract
Nasal contractures due to burns can cause collapse of the nasal aperture, leading to airway obstruction, correction of which requires surgical and prosthetic intervention. Prosthetically, a nasal conformer is the treatment of choice. Unfortunately even a well made nasal conformer has the disadvantage of being aesthetically unappealing and requires a retentive aid. An implant as a retentive aid is not always the option because of its high cost, rendering it unaffordable. Hence the purpose of this article is to describe the fabrication and use of a simple aesthetic nasal conformer to prevent the contracture of nasal aperture and maintain airway patency, thereby overcoming the demerits of a conventional nasal conformer. Introduction The facial region is a prime determinant of the physical attractiveness of individuals in their own eyes as well as in the eyes of others. The face serves as an important source of verbal & non-verbal communication that helps to regulate normal social interactions. Hence the face is said to be our window to the world1. Defects of the nose may result from congenital abnormalities, burn, trauma, tumor excision and complications of cosmetic or airway enhancement procedures2. In cases of acid burns, the damage to the biological structures depends on the concentration of the acid and the period of time before the acid is thoroughly washed off with water or neutralized with a neutralizing agent. The acid can rapidly eat way the skin, fat and fascia beneath the skin and in some cases even the underlying bone may be destroyed. It may also cause contractures resulting in shrunken nostrils due to destroyed cartilage and post operative fibrosis/ scarring3. Since the nose is a prominent feature of the face, and nasal deformities present complicated reconstruction problems, the correction or rehabilitation of this structure assumes great importance4. The treatment of such defects would require surgical and/or Prosthetic intervention to improve both form and function. Intranasal splints, stents like nasal conformer maintain airway patency, maintain tissue position, reduce tissue contracture after surgery or support mobile tissue in the construction and retention of facial prostheses5.6. Unfortunately, even a well made nasal conformer is not aesthetic and ill fitting due to lack of retentive aides. To overcome this, implants may be used as retentive aids7. But implants are expensive and unaffordable by most patients. Hence, the purpose of this article is to describe the fabrication and use of a simple, aesthetic, affordable nasal conformer to prevent the contracture of nasal aperture and maintain airway patency. Case report A 12 yr old patient with a history of acid burn on the right side of the face reported to the clinic (fig 1a).She presented with skin discoloration and scarring on the right side of the …show more content…
She reported that the incident occurred about 2 years ago when acid (sulphuric acid) used for checking the purity of milk in the milk centres splashed on the right side of her face. She was rushed to the nearby hospital where she received first aid. It included flushing of the damaged area with water and application of solution of bicarbonate of soda. As a definitive treatment, over a period of two years skin grafts were placed followed by coconut oil massage, steroid therapy, germ cell infiltration, laser therapy to tone the skin colour. However she complained of gradual constriction of her right nasal aperture and difficulty in breathing because of the closure.
As per our treatment plan, a nasal conformer was planned for the patient. She readily agreed for the same but requested that it be aesthetically acceptable and easy to wear. Hence it was decided to fabricate a nasal conformer using acrylic which is characterized to match the patient’s skin tone. A compressible nose stud, an ornament commonly worn by women in the Indian Sub-continent was chosen as a retentive aid for the nasal conformer making it more aesthetically appealing. The procedure is as