Osteoplasty in Crooked Nose Deformity: A Novel Approach

Abstract

Background

Crooked nose deformity is one of the most difficult issues to correct by rhinoplasty, as it can result in undesired late sequelae. Revision rates are often high, and numerous operational techniques have been tested. This study describes a crooked nose rhinoplasty technique that reduces the need for a double osteotomy in the long nasal bone.

Methods

This study included 26 patients with an I-shaped crooked nose deformity. In the surgical correction of the crooked nose deformity, previously defined techniques were applied to the cartilage identically. However, the traditional double osteotomy of the long nasal bone was not performed. Instead, the bone protruding laterally from the long nasal bone was narrowed by rasping with a file or burr, and this section was delivered to the maxilla accordingly. Angle values were measured preoperatively and postoperatively. Two lines were used to measure the angle: The first was drawn from the midpoint of the glabella to the midpoint of the upper lip, while the second, representing the nasal dorsal axis, consisted of both the osseous and cartilaginous parts from the nasion to the anterior nasal spine. The angle between these two lines was taken as the angle of deviation from the median line.

Results

Postoperatively, patients’ angle values were significantly smaller than preoperatively. After 1 year, no persistence was observed.

Conclusion

In crooked nose deformity surgery, the osteoplasty technique applied to the lateral protrusion of the long nasal bone described here was as successful as a double osteotomy. Thus, certain complications of a double osteotomy can be avoided. In addition, as no greenstick fractures were induced, the long-term persistence risk was also reduced.

Level of Evidence IV

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