{
  "abstract": "Background: Supernumerary nostril with an accessory nasal fistula is an exceptionally rare congenital anomaly with no standardised reconstructive protocol, especially with nasolacrimal involvement.\n\nCase report: A nine-year-old boy presented with a complete supernumerary nostril and synchronous accessory nasal fistula at the right alar base, persistent epiphora and prior endoscopic dacryocystorhinostomy. Imaging demonstrated a cystic tract communicating with the nasolacrimal system. Definitive management utilised a modified alar wedge excision type 2, incorporating both orifices into a single reconstructive unit. Three-month follow up demonstrated excellent aesthetic and functional outcomes with minimal scarring.\n\nLiterature review: A review of 12 previously published cases (2001–2025) revealed heterogeneous, largely non-standardised techniques, often relying on simple excision that may not correct alar asymmetry.\n\nConclusion: Complete tract eradication and restoration of alar symmetry were achieved. Alar wedge excision type 2 offers a reproducible technique for complex supernumerary nostril–accessory nasal fistula anomalies, particularly in Asian patients where tension-free closure minimises hypertrophic scarring.",
  "abstract_shown": true,
  "affiliations": [
    "Otorhinolaryngology-Head and Neck Surgery, Universitas Brawijaya, Indonesia"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Rizki Ekaputra Handoko"
    },
    {
      "affs": [
        0
      ],
      "name": "Iriana Maharani",
      "orcid": "0009-0006-8787-246X"
    },
    {
      "affs": [
        0
      ],
      "name": "Melody Audria Kurniadi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/64dc5j9c7mp85.bib",
  "cited_by": 0,
  "doi": "10.1017/s0022215126104824",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13719259/",
  "id": "64dc5j9c7mp85",
  "issns": [
    "0022-2151",
    "1748-5460"
  ],
  "landing_url": "https://doi.org/10.1017/s0022215126104824",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Records"
    ],
    [
      "openalex",
      "2716|Congenital Ear and Nasal Anomalies"
    ]
  ],
  "openalex": "W7163012098",
  "pdf_url": null,
  "pmcid": "PMC13719259",
  "pmid": "42219974",
  "published": "2026-10-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/64dc5j9c7mp85.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T12:23:07Z",
      "native_id": "PMC13719259",
      "source": "pmc",
      "url": "https://doi.org/10.1017/s0022215126104824"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2716|Congenital Ear and Nasal Anomalies",
      "subfield": "human-genetics"
    }
  ],
  "title": "Complete Supernumerary Nostril with Accessory Alar Fistula Reconstructed via Alar Wedge Excision Type 2: A Case Report and Literature Review",
  "title_text": "Complete Supernumerary Nostril with Accessory Alar Fistula Reconstructed via Alar Wedge Excision Type 2: A Case Report and Literature Review",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:23:07Z",
  "url": "https://research.draconitic.com/paper/64dc5j9c7mp85",
  "venue": "The Journal of Laryngology and Otology",
  "versions": []
}