Dra Ma Isabel Pérez López Burkle¹* and Dra Guadalupe Yarza Rosas²

¹Otolaryngology Chief of Service, National Institute of Rehabilitation “Luis Guillermo Ibarra Ibarra”, Mexico
²Medical Social Service, National Institute of Rehabilitation “Luis Guillermo Ibarra Ibarra”, Mexico

*Corresponding Author: Dra Ma Isabel Pérez López Burkle, Otolaryngology Chief of Service, National Institute of Rehabilitation “Luis Guillermo Ibarra Ibarra”, Mexico.

Received: December 09, 2025; Published: January 16, 2026

Abstract

The medial crura are fundamental components of the inferior lateral cartilages of the nose. Their function is to provide structural support to the nasal tip, maintain its projection and shape, and contribute to both nasal ventilation and aesthetics. Agenesis of these structures is a rare condition, with limited evidence in the literature.

We present the case of a 25-year-old female patient who underwent open rhinoseptoplasty due to functional and aesthetic concerns. During the surgical procedure, bilateral agenesis of the medial crura was identified as an incidental finding. The surgical technique used to correct this congenital malformation is described, utilizing autologous cartilage graft.

The literature mentions many possible causes, although these are not fully established. This anomaly may go unnoticed until adulthood and be discovered incidentally during nasal procedures. This case highlights the importance of considering rare idiopathic congenital malformations in patients with nasal symptoms, as well as the need to document such findings to improve future diagnostic and therapeutic approaches.

Keywords: Agenesis of Middle Crura; Congenital Nasal Malformations; Rhinoplasty; ANSA Banner

References

1. Losee JE., et al. “Congenital nasal anomalies: a classification scheme”. Plastic and Reconstructive Surgery2 (2004): 676-689.
2. Sadler TW. “Langman's Medical Embryology”. 14^th ed Philadelphia: Wolters Kluwer (2019): 274-276
3. Kosins AM., et al. “Rhinoplasty: congenital deficiencies of the alar cartilage”. Aesthetic Plastic Surgery6 (2013): 799-808.
4. Bran GM and Riedel F. “Dome reconstruction in a rare case of alar cartilage agenesis of the middle and lateral crura”. Aesthetic Plastic Surgery5 (2016): 685-689.
5. Baldi D., et al. “Rhinoplasty pre-surgery models by using low-dose computed tomography, magnetic resonance imaging, and 3D printing”. Dose-Response4 (2021): 15593258211060950.
6. Barone M., et al. “The role of skin thickness in the choice of a rhinoplasty technique for thin-skinned patients: analysis of long-term results and patient satisfaction”. Aesthetic Plastic Surgery5 (2020): 1742-1750.
7. De Poortere DA., et al. “Medpor en hipoplasia nasal: Agenesia de tercios superior, medio y septum nasal”. Acta Otorrinolaringol Cir Cabeza Cuello1 (2014): 49-53.
8. Osorio M., et al. “Aplasia congénita unilateral del cartílago alar”. Revista de Otorrinolaringología Y Cirugía De Cabeza Y Cuello 3 (2021): 379-382.
9. Patel KB., et al. “Anatomical study of the medial crura and the effect on nasal tip projection in open rhinoplasty”. Plastic and Reconstructive Surgery4 (2013): 787-793.
10. Kim YS., et al. “A comparative study of the medial crura of alar cartilages in unilateral secondary cleft nasal deformity: the validity of medial crus elevation”. Annals of Plastic Surgery4 (2008): 404-409.
11. Boynuyogun E and Tuncbilek G. “A Clinical Report of the Complete Nasal Agenesis: Reconstruction of congenital arhinia and review of the literature”. Cleft Palate Craniofacial Journal6 (2023): 752-757.

Citation

Citation: Dra Ma Isabel Pérez López Burkle and Dra Guadalupe Yarza Rosas. “Rhinoseptoplasty as Surgical Management in a Case of Agenesis of the Middle Nasal Crura".Acta Scientific Otolaryngology 8.2 (2026): 06-10.

Copyright

Copyright: © 2026 Dra Ma Isabel Pérez López Burkle and Dra Guadalupe Yarza Rosas. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.