Saddle nose deformity: pathological grading and anatomical reconstruction
Abstract Importance Management of saddle nose deformity needs to be directed toward diagnosing its etiology and its treatment. Objective The aim of this study was to propose a simple classification system for saddle nose deformity that depends on pathologic grading and anatomic reconstruction. Setti...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-02-01
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| Series: | The Egyptian Journal of Otolaryngology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.4103/1012-5574.199410 |
| _version_ | 1797203246565031936 |
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| author | Amr N. Rabie Ahmed Gamal |
| author_facet | Amr N. Rabie Ahmed Gamal |
| author_sort | Amr N. Rabie |
| collection | DOAJ |
| description | Abstract Importance Management of saddle nose deformity needs to be directed toward diagnosing its etiology and its treatment. Objective The aim of this study was to propose a simple classification system for saddle nose deformity that depends on pathologic grading and anatomic reconstruction. Setting This study was conducted at a university-affiliated tertiary hospital. Study design The study design was a retrospective chart review. Patients and methods Patients with saddle nose deformity presenting from 2012 to 2014 were reviewed. The patients were classified according to the septal condition as follows: grade 1, saddle nose due to pathology other than septal collapse (dorsum over-resection, familial, or racial); grade 2, septum is collapsed but can be fixed by means of bone grafts or septal replacement grafts; and grade 3, patients need cartilaginous septum reconstruction. Results The study included 32 patients, 20 female and 12 male, with a mean age of 27 years. Eleven cases were of grade 1 and were managed with dorsal grafts (septal cartilage in two, conchal cartilage in two, and diced cartilage in fascia in seven cases). Sixteen cases were of grade 2, and all were post-traumatic primary cases. Bone grafts to straighten and stabilize the broken septum were used in 13 cases, and septal replacement grafts were used in three cases. Five cases were of grade 3 and required replacement of septal L-strut that was concealed with diced cartilage in fascia. Columellar strut was used in all cases. Conclusion Diagnosis and management of saddle nose deformity should depend on identifying the etiology of each case and classifying them into cases due to correctable septal pathology that can be managed with straightening the septum, or those due to missing septum that need septal reconstruction, and those due to low dorsum without septal pathology that can be simply corrected with dorsal grafts. Using this anatomical approach we are trying to achieve a strong esthetic pleasing functioning nose. |
| first_indexed | 2024-04-24T08:16:17Z |
| format | Article |
| id | doaj.art-9aa75a51c90543f7a4601030027a5af2 |
| institution | Directory Open Access Journal |
| issn | 1012-5574 2090-8539 |
| language | English |
| last_indexed | 2024-04-24T08:16:17Z |
| publishDate | 2017-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Otolaryngology |
| spelling | doaj.art-9aa75a51c90543f7a4601030027a5af22024-04-17T03:34:22ZengSpringerOpenThe Egyptian Journal of Otolaryngology1012-55742090-85392017-02-01331313610.4103/1012-5574.199410Saddle nose deformity: pathological grading and anatomical reconstructionAmr N. Rabie0Ahmed Gamal1Department of Otorhinolaryngology, Ain Shams UniversityDepartment of Otorhinolaryngology, Ain Shams UniversityAbstract Importance Management of saddle nose deformity needs to be directed toward diagnosing its etiology and its treatment. Objective The aim of this study was to propose a simple classification system for saddle nose deformity that depends on pathologic grading and anatomic reconstruction. Setting This study was conducted at a university-affiliated tertiary hospital. Study design The study design was a retrospective chart review. Patients and methods Patients with saddle nose deformity presenting from 2012 to 2014 were reviewed. The patients were classified according to the septal condition as follows: grade 1, saddle nose due to pathology other than septal collapse (dorsum over-resection, familial, or racial); grade 2, septum is collapsed but can be fixed by means of bone grafts or septal replacement grafts; and grade 3, patients need cartilaginous septum reconstruction. Results The study included 32 patients, 20 female and 12 male, with a mean age of 27 years. Eleven cases were of grade 1 and were managed with dorsal grafts (septal cartilage in two, conchal cartilage in two, and diced cartilage in fascia in seven cases). Sixteen cases were of grade 2, and all were post-traumatic primary cases. Bone grafts to straighten and stabilize the broken septum were used in 13 cases, and septal replacement grafts were used in three cases. Five cases were of grade 3 and required replacement of septal L-strut that was concealed with diced cartilage in fascia. Columellar strut was used in all cases. Conclusion Diagnosis and management of saddle nose deformity should depend on identifying the etiology of each case and classifying them into cases due to correctable septal pathology that can be managed with straightening the septum, or those due to missing septum that need septal reconstruction, and those due to low dorsum without septal pathology that can be simply corrected with dorsal grafts. Using this anatomical approach we are trying to achieve a strong esthetic pleasing functioning nose.http://link.springer.com/article/10.4103/1012-5574.199410diced cartilagediced cartilage in fasciarhinoplastysaddle noseseptum reconstruction |
| spellingShingle | Amr N. Rabie Ahmed Gamal Saddle nose deformity: pathological grading and anatomical reconstruction The Egyptian Journal of Otolaryngology diced cartilage diced cartilage in fascia rhinoplasty saddle nose septum reconstruction |
| title | Saddle nose deformity: pathological grading and anatomical reconstruction |
| title_full | Saddle nose deformity: pathological grading and anatomical reconstruction |
| title_fullStr | Saddle nose deformity: pathological grading and anatomical reconstruction |
| title_full_unstemmed | Saddle nose deformity: pathological grading and anatomical reconstruction |
| title_short | Saddle nose deformity: pathological grading and anatomical reconstruction |
| title_sort | saddle nose deformity pathological grading and anatomical reconstruction |
| topic | diced cartilage diced cartilage in fascia rhinoplasty saddle nose septum reconstruction |
| url | http://link.springer.com/article/10.4103/1012-5574.199410 |
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