Three-step reconstruction of complex saddle nose deformities

Area of Science:

• Plastic Surgery
• Otolaryngology
• Reconstructive Surgery

Background:

• Complex saddle nose deformities involve significant loss of nasal structure and support.
• These deformities often result in multiple aesthetic and functional abnormalities.
• Previous reconstructive attempts may complicate further surgical interventions.

Purpose of the Study:

• To evaluate a reproducible surgical technique for augmentation rhinoplasty in complex saddle nose deformities.
• To assess the efficacy and outcomes of a standardized 3-step surgical procedure using autogenous costal cartilage.
• To determine the long-term functional and aesthetic results in patients with severe nasal structural loss.

Main Methods:

• A case series and surgical outcome study was conducted at a tertiary referral center.
• Forty-three patients with complex saddle nose deformities underwent a standardized 3-step reconstruction using autogenous costal cartilage.
• Outcomes assessed included nasal abnormalities, graft site conditions, complications, analgesic use, and subjective patient satisfaction at 2 years post-surgery.

Main Results:

• One transplant extrusion required revision surgery; 8 patients had minor surgical corrections.
• Thirty of 37 patients reported satisfactory or good nasal airflow.
• Seventeen patients considered aesthetic appearance good, 10 satisfactory, and 10 unsatisfactory.

Conclusions:

• The 3-step nasal reconstruction with costal cartilage is effective for severe saddle nose deformities.
• This technique is a reliable surgical option, providing satisfying results in challenging cases.
• The procedure demonstrates efficacy even with unfavorable recipient site conditions and extensive prior surgeries.