Case Details
Saddle Nose Deformity
The saddle nose represents a gradual or stepped dip in the bridge of the nose. We don’t need to go into causes, but rest assured they are most commonly traumatic in origin. Apart from the aesthetic unbalance, many people with a saddle nose experience a compromised nasal airway, the dipped nasal bridge pinching the vault of the nose and this portion of the airway. And so the motivation to have this fixed is often twofold.
We could divide the nose into an upper portion which is the bony pyramid and a middle portion which is the cartilaginous vault and a lower portion which is the nasal tip. Any loss of projection can create or contribute to a saddle process, and so the reconstruction of the saddle is dictated in part by the injured portion of anatomy. The bony bridge could be lowered. The middle, cartilaginous vault, a dome-like structure, can be lifted or layered. The nasal tip can be adjusted in terms of projection and angulation, proportionate to the rest of the bridge anatomy. It’s all about restoring the natural balance or harmony of all of the anatomical elements in the nose, aesthetic, structural and functional.
This lady suffered a crush trauma to her nose, with a dislocation and retro projection of the middle, cartilaginous vault. Elevation of the middle vault with spreader and batton and onlay grafts lifted up this anatomy. Modest polishing or rasping of the bony bridge matched to create a smooth bridge. The nasal tip was repositioned, derotated and reprojected to fit the bridge structure. Mission accomplished.
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