Seeking Solutions for Nasal Reconstruction After Failed Surgery

Remedy for the Nose~

Hello Doctor: I am a victim of a nasal procedure performed by a traditional Chinese medicine practitioner ten years ago.
Due to improper handling by the physician, I have developed adhesion and deviation of the nasal septum, resulting in uneven thermal injury to both nostrils.
(For details on the medical procedure, please refer to http://tw.myblog.yahoo.com/jw!G63u032RHRQg9_TeWw--/article?mid=353&next=349&l=f&fid=15) One nostril has only mild thermal injury at the anterior part, and the mucosa of the inferior turbinate remains intact, allowing for some airflow.
However, the other nostril has been severely burned, almost to the deepest part of the nasal cavity: the mucosa of both the inferior and middle turbinates is completely necrotic and fibrotic (and possibly even deeper), and the eye on that side has also lost vision due to an injury from improper handling.
Currently, the remaining issue is that I cannot breathe properly through the severely burned nostril, I have lost my sense of smell, and I frequently cough, leading to upper respiratory viral infections and bronchitis.
I have consulted various hospitals and clinics, but there seems to be no remedy.
The nasal cavity imaging shows a clear visual difference in the mucosa of both turbinates: http://tw.myblog.yahoo.com/jw!G63u032RHRQg9_TeWw--/photo?pid=110 http://tw.myblog.yahoo.com/jw!G63u032RHRQg9_TeWw--/photo?pid=281 http://tw.myblog.yahoo.com/jw!G63u032RHRQg9_TeWw--/photo?pid=282 I inquired about this issue with an ENT physician from Taiwan's E Hospital website.
I suggested that patients with nasal septal perforation could use silicone to fill the gap, so I thought of using a similar "prosthetic" function by inserting something like a cork or foam material, or even other slightly breathable materials, to block that nostril.
This way, I would avoid using that side for breathing and force myself to breathe through the other nostril, which could help prevent respiratory infections.
However, the ENT physician advised me to consult a plastic surgeon.
Therefore, I am presenting this question here, hoping to receive your professional response regarding any potential corrective measures in the field of plastic surgery.
Thank you, Doctor; I greatly appreciate your help.

Shan, 20~29 year old female. Ask Date: 2010/05/26

Dr. Zhou Hongzhang reply Plastic Surgery

Our hospital is currently unable to provide this type of rhinoplasty.
You may seek consultation and assistance at a larger medical center in Taipei.

Reply Date: 2010/05/26

More Info

It sounds like you have been through a very challenging and distressing experience with your nasal surgery, and I commend you for seeking further solutions. Your situation, involving significant nasal damage and complications from a previous procedure, requires careful consideration and a multidisciplinary approach.

Understanding Your Condition
From your description, it appears that you have suffered from severe nasal mucosal damage, particularly on one side, which has resulted in significant functional impairment, including loss of smell and difficulty breathing. The fact that one side of your nasal cavity has been more severely affected, leading to fibrosis and necrosis of the nasal turbinates, complicates your situation further. The loss of vision in the affected eye adds another layer of complexity, indicating that the initial procedure may have had unintended consequences.

Potential Solutions
1. Nasal Reconstruction Surgery: Given the extent of the damage, a consultation with a plastic surgeon specializing in facial reconstruction or an otolaryngologist (ENT) with expertise in nasal surgery would be essential. They can evaluate the structural integrity of your nasal passages and determine if reconstruction is feasible. Techniques such as grafting healthy tissue from other areas (like the ear or other parts of the nasal cavity) may be considered to restore function and aesthetics.

2. Silicone Implants or Prosthetics: Your idea of using a silicone implant or a similar material to fill the affected nasal cavity could be a temporary solution to prevent further complications. However, this should be done under medical supervision to avoid any risk of infection or further damage. A prosthetic device could potentially help maintain the shape of the nasal cavity while allowing for some airflow through the unaffected side.

3. Nasal Valve Surgery: If the nasal obstruction is significant, procedures to improve airflow through the unaffected side may be necessary. This could involve nasal valve surgery, which aims to enhance the structural support of the nasal passages.

4. Management of Symptoms: In the meantime, managing your symptoms is crucial. This may include using saline nasal sprays to keep the mucosa moist, avoiding irritants, and possibly using medications to manage any chronic cough or bronchitis symptoms resulting from your nasal issues.

5. Multidisciplinary Approach: It may be beneficial to involve a team of specialists, including an ENT, a plastic surgeon, and possibly a pulmonologist, to address the respiratory complications you are experiencing. They can work together to create a comprehensive treatment plan tailored to your needs.

Conclusion
Your situation is indeed complex, and while there are potential avenues for treatment, the success of any surgical intervention will depend on a thorough assessment by qualified specialists. I encourage you to seek out a medical center with a strong reputation in reconstructive surgery and nasal disorders. They will be able to provide you with the most appropriate options based on your specific condition.
Please remember that recovery and improvement may take time, and it's essential to have realistic expectations while exploring these options. I wish you the best of luck in your journey toward recovery and improved quality of life.

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