The staged management of an 8-month-old boy with congenital tubular nostril, or proboscis lateralis, is described. Absent were the right frontal and maxillary sinuses, right nasolacrimal apparatus, vomer, and right lateral nasal wall. Present was a ldquo;baby elephant trunkrdquo; attached to the right medial canthal region.Attachment of the tubular nostril was carried out in two stages. A bipedicle with serrated edges was created from the soft tissues of the right medial cheek. Under this was buried the lower two-thirds of the tubular nostril previously deepithelialized circumferentially with a similar serrated outline. Five months later, the remaining upper third of the tubular nostril was deepithelialized, detached from its origin in the medial canthal region, and similarly buried under a bipedicle tunnel. Adjustments of the alar rim, alar base, and nasal tip were done by excisions and Z-plasty. Exostosectomy at the right medial canthal region provided further refinement.No retardation of growth was evident after 4 years.
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