The Crooked Nose-Surgical Algorithm in Post-Traumatic Patient-Evaluation of Surgical Sequence

Background: A crooked nose is a challenge for a surgeon performing rhinoplasty. When performed correctly, rhinoseptoplasty aligns the nasal framework, restores nasal patency, and achieves facial symmetry. The key to this procedure is to dissect all the structures of the nasal framework, mobilize, reposition, and stabilize them. Aim: This study aims to discuss the quality of life after the rhinoseptoplasty and principles of treating a post-traumatic crooked nose with a view to improving the predictability and reliability of rhinoplasty procedures involving this challenging problem. Methods: The study compared the results of the Rhinoplasty Outcome Evaluation (ROE) and the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) through statistical analysis. Results: Considering the structural deformities that lead to a crooked nose, the open approach seems to be preferred during a rhinoseptoplasty of a post-traumatic, crooked nose. When reconstructing the nasal septum, it is always necessary to leave the required amount of cartilage to provide nasal support and to secure the septum to the nasal spine. Osteotomies are important for fixing a crooked nose. The preoperative values for ROE were significantly lower before surgery than after surgery (8.7 vs. 20.2), while for SCHNOS, the postoperative values were statistically significantly lower compared to the preoperative values (46.0 vs. 9.1). Conclusions: Properly planned and performed surgery improves the functional and aesthetic outcomes in patients after rhinoseptoplasty.