Cartilage grafts in dorsal nasal augmentation of traumatic saddle nose deformity: A long‐term follow‐up

Mao, Johnny C.; Carron, Michael A.; Tomovic, Senja; Narasimhan, Kailash; Allen, Shannon H.; Mathog, Robert H.

doi:10.1002/lary.20491

Cited by 19 publications

(19 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A few studies have reported surgical outcomes of saddle nose. In a review of 20 saddle nose cases, Mao et al 13 reported that only 5% had unsuccessful surgical results. There could be several reasons why the surgical results of the study by Mao et al were considerably better than ours.…”

Section: Discussionmentioning

confidence: 98%

Treatment Outcomes of Saddle Nose Correction

Hyun

Jang

2013

JAMA Facial Plast Surg

View full text Add to dashboard Cite

addle nose deformity results from disruption of bx;1the baseptal support and is characterized by middle vault depression and widening, columellar retrusion, tip overrotation, deprojection, and nasal shortening. 1 Nasal obstruction caused by collapse of the upper and lower cartilages is also a frequent finding. 2 Saddle nose is a common deformity encountered in rhinoplasty, yet it remains one of the most challenging deformities to treat. 3 Although several articles 2,4,5 that introduce surgical techniques for saddle nose correction are available, few articles address the surgical outcomes and difficulty of saddle nose correction.Many valuable classification schemes for saddle nose have been suggested that integrate clinical deformity and treatment, including those by Vartanian, 6 Tardy et al, 7 and Daniel and Brenner. 8 Overall, there is no consensus regarding the most suitable classification and surgical method for saddle nose correction. In our rhinoplasty practice for Asian nose, we identified many patients whose saddle noses do not fit exactly into the classification systems proposed previously. Therefore, we developed a modified saddle nose classification to supplement the limitations of previous classifications.The present study retrospectively analyzed 91 patients with saddle nose for cause, treatment methods, and aesthetic outcomes, according to a modified classification scheme. This study could provide insight into the management of saddle nose for rhinoplasty surgeons. IMPORTANCE Many valuable classification schemes for saddle nose have been suggested that integrate clinical deformity and treatment; however, there is no consensus regarding the most suitable classification and surgical method for saddle nose correction. OBJECTIVES To present clinical characteristics and treatment outcome of saddle nose deformity and to propose a modified classification system to better characterize the variety of different saddle nose deformities. DESIGN, SETTING, AND PARTICIPANTS The retrospective study included 91 patients who underwent rhinoplasty for correction of saddle nose from April 1, 2003, through December 31, 2011, with a minimum follow-up of 8 months. Saddle nose was classified into 4 types according to a modified classification. MAIN OUTCOME AND MEASURE Aesthetic outcomes were classified as excellent, good, fair, or poor.RESULTS Patients underwent minor cosmetic concealment by dorsal augmentation (n = 8) or major septal reconstruction combined with dorsal augmentation (n = 83). Autologous costal cartilages were used in 40 patients (44%), and homologous costal cartilages were used in 5 patients (6%). According to postoperative assessment, 29 patients had excellent, 42 patients had good, 18 patients had fair, and 2 patients had poor aesthetic outcomes. No statistical difference in surgical outcome according to saddle nose classification was observed. Eight patients underwent revision rhinoplasty, owing to recurrence of saddle, wound infection, or warping of the costal cartilage for dorsal augmentation.CONCLUSIO...

show abstract

Section: Discussionmentioning

confidence: 98%

Treatment Outcomes of Saddle Nose Correction

Hyun

Jang

2013

JAMA Facial Plast Surg

View full text Add to dashboard Cite

show abstract

“…Dorsal augmentation can be used when there is severe injury and deflection, as well as in the weak or cartilage depleted nose. 3 Dorsal augmentation aims to improve the dorsal profile as well as conceal traumatic deformities (►Fig. 8A-C).…”

Section: Dorsal Augmentationmentioning

confidence: 99%

“…These deformities are caused by collapse of the dorsal and/or caudal nasal septum following traumatic septal dislocation from the bony nose due to high-impact trauma or necrosis of the cartilage from septal hematoma nasal. 3 Reconstruction of saddle nose deformities is challenging. It is important to determine the severity of the saddle nose deformity.…”

Section: Dorsal Augmentationmentioning

confidence: 99%

“…For these patients dorsal onlay grafts can be used as cosmetic concealment. 3 These options have been previously discussed above. Patients with more severe injury will start to have associated structural collapse with compromise of septal support, midvault collapse columellar retraction, and loss of nasal tip support.…”

Section: Dorsal Augmentationmentioning

confidence: 99%

“…Severe trauma to the nasal midvault and collapse of the nasal septum can lead to saddle nose deformity. 3 Traumatic septal hematoma with resultant septal abscess and septal necrosis can result in the same deformity. The severity of this deformity varies significantly.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Cosmetic Concerns Related to the Posttraumatic Nose without Nasal Obstruction

Farrior

Eisler

2015

Facial plast Surg

View full text Add to dashboard Cite

Because of its prominent position on the facial skeleton, the nose is commonly injured. Though significant trauma can result in nasal obstruction, there is also considerable concern for potential cosmetic deformity. Repairing traumatic deformities is complex and can involve all aspects of the nose, including the bony and cartilaginous framework as well as the soft tissue envelope. Trauma can result in deflection, asymmetry, and deformity of the bony nasal dorsum, midvault, and nasal tip. Any serious nasal trauma places patients at risk for complications that may include nasal septal hematoma, septal perforation, and possible cerebral spinal fluid leak. Unrecognized or untreated septal hematomas can result in cartilaginous septal necrosis followed by saddle nose deformity. Though damage to structural scaffolding is often the cause of cosmetic deformity following nasal trauma, the nasal soft tissue envelope is also commonly affected. This can result in lacerations, avulsions, and traumatic tattooing. The following will discuss the evaluation, diagnosis, and management of these cosmetic concerns relating to nasal trauma.

show abstract