PMC8407622_01
(a) Preoperative view showing increased intercanthal distance (68 mm), broad and flat nasal bridge, deformed nasal tip, (b and c) three-dimensional computed tomography scan revealed the absence of nasal bones with square-shaped head and temporal displacements of orbits
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F1
The intercanthal distance was 68 mm [Figure 1a]. Imaging with three-dimensional computed tomography (CT) scan revealed the absence of nasal bones with square-shaped head, and temporal displacements of orbits [Figure 1b and c].
(a) Vertical osteotomy cuts placed perpendicular to the frontal bar, (b) circumferential osteotomy around the orbit was carried out, (c) removed median segment, (d) large asymmetrical critical-sized dural matter tear was observed at the anterior cranial fossa
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F2
The patient recovered uneventfully and there was no clinical evidence of CSF leak or nasal encepaholcele [Figures 2-4].
(a) Fat and fascia lata were harvested from the lateral aspect of the right thigh, (b and c) fibrin sealants were sandwiched in between the fascial graft. Surgicell  was used to achieve haemostasis
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F3
The patient recovered uneventfully and there was no clinical evidence of CSF leak or nasal encepaholcele [Figures 2-4].
(a and b) Fixations of the other segments were done using titanium plates and screws, (c) scalp were re-draped and sutured with 2.0 vicryl, surgical drain was placed and staples were placed, (d) postoperative view reduced interocular distance
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F4
The patient recovered uneventfully and there was no clinical evidence of CSF leak or nasal encepaholcele [Figures 2-4].