Straight Septum, Crooked Nose: An Overlooked Concept

• Published in: Aesthetic plastic surgery Vol. 38; no. 1; pp. 32 - 40
• Main Authors: Hafezi, Farhad, Naghibzadeh, Bijan, Ashtiani, Abbas Kazemi, Guyuron, Bahman, Nouhi, Amir Hossein, Naghibzadeh, Ghazal
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.02.2014; Springer Nature B.V
• Subjects: Adult; Female; Humans; Male; Medicine; Medicine & Public Health; Nasal Cartilages - abnormalities; Nasal Cartilages - surgery; Nasal Septum; Original Article; Otorhinolaryngology; Plastic Surgery; Rhinoplasty; Young Adult; Crooked nose; Upper lateral cartilage; Postoperative deformities
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-013-0230-1

Introduction Asymmetric facial skeletal growth is a common finding in the rhinoplasty patient population. This common abnormality affects all facial components, including the upper lateral cartilages (ULCs). The asymmetric growth also may produce uneven thickness, consistency, curvature, and elastic recoil of the ULC. Ignoring this asymmetry may have a marked impact on the outcome of any rhinoplasty operation, especially in the management of crooked noses. Materials and Methods The files of 89 consecutive rhinoplasty patients who underwent surgery by a single surgeon were reviewed for deformities of the middle vault and to tabulate the procedures performed in each individual case. Results Of the 89 rhinoplasty cases, 72 (81 %) had asymmetric ULCs. Approximately 30 % (27/89) of the cases had a straight septum with asymmetric ULCs which required appropriate correction. Conclusions Awareness of an asymmetric ULC in a crooked nose and an attempt to correct this condition in addition to straightening of the septum is key to decreasing postoperative residual or recurrent mid-vault deviation. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .