Treatment for Persistently Twisted Nose
Posted on 2010-01-12 12:01:25
Many patients who have previously sustained nasal fractures and have previously undergone close reduction of nasal fracture will require definitive treatment of their persistently twisted nose. Furthermore, many patients who have undergone full rhinoplasty procedures for a twisted nose may continue to have some evidence of crooked nose and as a result will seek further secondary or tertiary rhinoplasty procedure to address their persistently twisted and crooked nose deformity.
Dr. Azizzadeh one of the leading experts in primary and revision rhinoplasty, at the time of the consultation will evaluate the patient’s nose both for its aesthetics and function as many patients will have nasal airway obstruction and breathing difficulties because of a fractured septum and internal nasal vault collapse. Most patients for revision rhinoplasty and a persistently crooked nose do not have problems with their nasal bones per se, but rather have persistent problems with their nasal cartilages in the middle portion of the nose, also noted as a middle nasal vault.
Most crooked nose deformities involve poor aesthetics in the transition between the nasal bone, which makes up the upper portion of the nose, and the nasal cartilages in the middle nasal vault. The middle nasal vault is very sensitive to damage in trauma as the cartilages in that area can easily be avulsed and separated from the nasal bone. Hence, the aesthetics of the nose appears to be crooked as the nasal bone is still maintained in the middle portion whereas the nasal cartilages are separated. During the time of the revision rhinoplasty, Dr. Azizzadeh will reconstitute the middle nasal vaults utilizing spreader grafts and suture grafts to better symmetrize the middle nasal vaults to the nasal tip as well as the nasal bones. If the nasal tip is also in a crooked position, the septum and the cartilages of the nasal tip will be reconstructed to bring the entire nose into alignment with each subunit. Occasionally if the nasal bone is still persistently crooked, deviated and asymmetric, then the nasal bones need to be re-fractured (undergo osteotomy re-fracture). The fracture of the nasal bone often requires differential fracturing of the right and left side in order to bring the nasal bones back into the middle portion and in balance with the rest of the nose.