Proboscis Lateralis Associated With Cleft Palate: A Pragmatic Surgical Strategy in a Syndromic Child

Proboscis lateralis is a rare congenital nasal anomaly frequently associated with complex craniofacial and systemic malformations. Considerable variability exists regarding the timing, extent, and objectives of reconstruction, particularly in syndromic patients. We report a six-year-old girl with proboscis lateralis, cleft palate, severe unilateral nasal maldevelopment, ocular anomalies, sensorineural hearing loss, and neurodevelopmental delay. Surgical management consisted of cleft palate repair combined with staged external cosmetic reconstruction of the proboscis lateralis at six years of age. Intranasal exploration or airway reconstruction was not within the scope of the intervention. Early postoperative results at 3-month follow-up demonstrated stable healing, improved facial symmetry, and no complications. This case illustrates an anatomy-driven, function-aware, staged surgical strategy in which external reconstruction is pursued as a defined and limited objective. In selected patients with complex nasal developmental anomalies, such a pragmatic approach may provide meaningful benefit while preserving future reconstructive options and minimizing morbidity by prioritizing proportional benefit over anatomical completeness.