Hybrid Technique in Crooked Nose Correction: Evolution of the Asymmetric Letdown Approach

Area of Science:

• Plastic Surgery
• Otolaryngology
• Facial Plastic Surgery

Background:

• Crooked nose deformities present significant surgical challenges due to complex bony and cartilaginous asymmetries.
• The Hybrid Technique integrates preservation and structural rhinoplasty principles for efficient and effective correction.

Purpose of the Study:

• To compare the efficacy and outcomes of the Hybrid Technique versus the Pisa Tower technique for correcting crooked nose deformities.
• To evaluate objective and subjective results, including nasal axis deviation, symmetry, and patient-reported functional improvement.

Main Methods:

• A retrospective study of 54 patients undergoing primary rhinoplasty for crooked noses.
• Comparison between 28 patients treated with the Pisa Tower technique and 26 with the Hybrid Technique.
• Objective assessment via standardized photographs and CT scans; subjective assessment using the NOSE questionnaire at 12 months.

Main Results:

• Both techniques significantly improved nasal alignment and patient-reported outcomes (NOSE scores).
• No significant differences were found between the Hybrid Technique and Pisa Tower technique in terms of nasal axis deviation, R-Webster triangle symmetry, or functional improvement.
• Operative times and complication rates were comparable between the two techniques.

Conclusions:

• The Hybrid Technique offers reproducible correction for nasal asymmetry, comparable to the Pisa Tower approach.
• It presents a versatile and effective option for managing complex nasal deviations with similar functional outcomes and procedural efficiency.
• Both techniques demonstrate successful correction of crooked nose deformities.