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Refinements in Saddle Nose Reconstruction.

Yung Yuan Chen1, Yong Ju Jang2

  • 1Department of Otolaryngology, Cathay General Hospital, Taipei, Taiwan.

Facial Plastic Surgery : FPS
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Saddle nose correction is complex, often caused by trauma or surgery. This study introduces a new classification and surgical techniques, including major septal reconstruction and dorsal implants, for improved aesthetic and functional outcomes.

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Reconstructive Surgery

Background:

  • Saddle nose deformity presents significant aesthetic and functional challenges in rhinoplasty.
  • Common etiologies include nasal trauma and previous septal surgeries, often resulting in septal spine and caudal septum defects.

Purpose of the Study:

  • To propose a novel classification system for saddle nose deformities.
  • To outline diverse surgical strategies tailored to the severity of saddle nose.

Main Methods:

  • Development of a new saddle nose classification system.
  • Application of reconstructive techniques: extended spreader grafts, caudal extension grafts, extracorporeal L-struts, integrated dorsal implants, and premaxillary plumping grafts.
  • Management considerations for autoimmune-related cases.

Main Results:

  • The proposed classification aids in selecting appropriate surgical approaches.
  • Major septal reconstruction is advocated for most cases.
  • Advanced techniques like integrated dorsal implants offer solutions for extreme cases without extensive dissection.
  • Grafting techniques provide further augmentation and correction of retracted columella.

Conclusions:

  • A structured approach to saddle nose correction, guided by a new classification, can yield successful aesthetic and functional results.
  • Surgical intervention is safe for autoimmune-related saddle nose when the disease is controlled.