{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:40:11Z","timestamp":1793652011844,"version":"4.5.1"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,9,21]],"date-time":"2017-09-21T00:00:00Z","timestamp":1505952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Patients who have granulomatosis with polyangiitis (<jats:styled-content style=\"fixed-case\">GPA<\/jats:styled-content>, syn. M. Wegener) often develop an external nose deformity which may have devastating psychological effects. Therefore, reconstruction of nasal deformities by rhinoplasty may become necessary to achieve a normal appearance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective of review<\/jats:title><jats:p>The aim of this systematic review was to investigate the efficacy and safety of surgical reconstruction in external nasal deformities and septal perforation in <jats:styled-content style=\"fixed-case\">GPA<\/jats:styled-content> patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>A systematic literature search with defined search terms was performed for scientific articles archived in the <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\u2010Database up to 10 June 2016 (PubMed Advanced <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content> Search), describing management of cases or case series in <jats:styled-content style=\"fixed-case\">GPA<\/jats:styled-content> patients with saddle nose deformity and\/or septal perforation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven of 614 publications met the criteria for this analysis including 41 <jats:styled-content style=\"fixed-case\">GPA<\/jats:styled-content> patients undergoing external nasal reconstruction and\/or septal reconstruction with a median follow\u2010up of 2.6\u00a0years. Overall, saddle nose reconstruction in <jats:styled-content style=\"fixed-case\">GPA<\/jats:styled-content> patients is safe even if an increased rate of revision surgery has to be expected compared with individuals without <jats:styled-content style=\"fixed-case\">GPA<\/jats:styled-content> undergoing septorhinoplasty. Most implanted grafts were autografts of calvarial bone or costal cartilage. For septal perforation reconstruction, few studies were available. Therefore, based on the available data for surgical outcomes, it is impossible to make evidence\u2010based recommendations. All included <jats:styled-content style=\"fixed-case\">GPA<\/jats:styled-content> patients had minimal or no local disease at the time of reconstructive surgery. Therefore, the relationship between disease activity and its impact on surgical outcomes remains unanswered. The potential impact of immune\u2010modulating medications on increased complication rates and the impact of prophylactic antibiotics are unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study systematically reviews the efficacy and safety of surgical reconstruction of external nasal deformities in <jats:styled-content style=\"fixed-case\">GPA<\/jats:styled-content> patients for the first time. Saddle nose reconstruction in <jats:styled-content style=\"fixed-case\">GPA<\/jats:styled-content> patients with minimal or no local disease is a safe procedure despite an increased rate of revision surgery. Further research is required regarding the impact of antibiotic prophylaxis, immune\u2010modulating therapy, long\u2010term outcomes and functional outcomes measured with subjective and objective parameters.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.12977","type":"journal-article","created":{"date-parts":[[2017,9,7]],"date-time":"2017-09-07T13:58:52Z","timestamp":1504792732000},"page":"291-299","source":"Crossref","is-referenced-by-count":27,"title":["Saddle nose deformity and septal perforation in granulomatosis with polyangiitis"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3520-0638","authenticated-orcid":false,"given":"A.","family":"Coordes","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery Berlin Institute of Health Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin corporate member of Freie Universit\u00e4t Berlin Humboldt\u2010Universit\u00e4t zu Berlin Campus Benjamin Franklin Berlin 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