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Proboscis Lateralis Three Cases Report

Dr. Kamal Abou-Elhamd MD

Professor in ENT
Al-Ahsa College of Medicine
King Faisal University
Email: Kamal375@yahoo.com
12/08/21 Website: www.geocities.com/kamal375/papers.html
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 Proboscis Lateralis: 3 Cases

 These are 3 cases of the rare anomaly

PL.
 one presented with right PL
 and two presented with left PL

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 Case1

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 Case 2

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 Case 3

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 Proboscis Lateralis
 In this rare anomaly, the nasal cavity
on one side is completely normal while
on the affected side, the nasal cavity is
replaced by a tube of skin and soft
tissue attached to the inner canthus of
the eye.
 This anomaly occurs sporadic as an
isolated defect or in association with
other anomalies.
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 Proboscis Lateralis
 It is usually associated with
failure of the paranasal sinuses
and the nasolacrimal duct
development.
 Embryologically, this anomaly is
a result of imperfect fusion of the
lateral nasal wall and maxillary
processes .
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 Case 3
 CT revealed
agenesis of the left
nasal cavity, left
maxillary sinus and
ethmoidal air cells,
a nasal septum was
present

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3-dimensional image revealed completely sealed off left pyriform
aperture by bone
There was a bony notch of the antero-superior part of medial wall
of left orbit

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3-dimensional image also revealed a separate bone in the tube

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 Axial CT revealed a
canal through the
process which ended
blindly with a bone
along the process
 There was a central
canal, injection of
lipidol through it did not
appear into the
nasopharynx on X-ray
lateral view

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 Embryology
 Imperfect fusion of the lateral nasal wall and
maxillary processes lead to PL.
In another theory, this is a result of fusion of the
maxillary process of the affected side with the
globular and nasal processes of the opposite side
.

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 Diagnosis

 This is easy by the obvious

abnormality seen on physical
examination and CT scanning

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 Treatment
 Repair of the deformity after complete facial
growth.
 The repair is faciliated by reconstruction of
the nose using the attached tube of the skin
and soft tissues.

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 Treatment
 The proboscis is split ventro-medially and
the cut edges are sutured to the pyriform
margin and nasal dorsum after removal of
bone occluding the aperture
 So, it is advised to preserve the attached
skin tube to help in repair. Bone and
cartilage grafts are necessary for support.
 Dacryocystorhinostomy should be done.

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 NOTE
 The first 2 cases were published in the
international journal of pediatric
otolaryngology2004;68:503-505. Proboscis
lateralis a report of 2 cases.
 The 3rd case was published in the
JLO2005;119:158-160. Proboscis lateralis
clinical and radiological features.

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 Proboscis Lateralis 3 Cases Report

Thank You
Dr. Kamal Abou-Elhamd MD
Professor in ENT
Al-Ahsa College of Medicine
King Faisal University
Email: Kamal375@yahoo.com
12/08/21 Website: www.geocities.com/kamal375/papers.html
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