Correction of Saddle Nose Deformities
SADDLE NOSE occurs second in frequency to the hump nose deformity among the malformations observed in rhinoplastic practice.
On an etiologic basis saddle nose deformities may be grouped in three broad categories: congenital — a relatively uncommon occurrence; infectious — generally associated with syphilis but often a sequela of pyogenic septal abscess; traumatic — resultant from a direct external blow or the consequence of extensive septal resection.
Despite the etiologic factor involved, these deformities have certain points in common:
On the profile projection there is a scapha involving all or a portion of the cephalad two-thirds of the nasal dorsum.
On full face observation a real or apparent widening of the nasal dorsum is demonstrated.
A decrease of function results due to a decrease in the anteroposterior diameter of the airway.
Except for the minor deformities which can be corrected by a rearrangement of the existent nasal structures, all corrective procedures are based on the premise of camouflaging the defect by means of some type of implant.
Over the years many substances have been recommended for building up tissue defects. Most of these were incapable of becoming an integral part of the tissues and sooner or later either shifted or provoked sufficient inflammatory reaction to necessitate their removal. The materials that have best withstood the test of time are autogenous cancellous bone, usually obtained from the iliac crest, autogenous rib cartilage, and isografts of rib cartilage preserved according to the technic of Pierce and O’Connor. In Case 1, preserved rib. . .