Correction of Severe Deviated Nose by Intermediate Short Osteotomy

Abstract

BACKGROUND The deviated nose is a common deformity encountered in rhinoplasty, and yet it is the most challenging pathology to treat, because multiple internal and external structures have deformity, so there is a need to be corrected. METHODES The intermediate short osteotomy has been applied as a technique to correct severe nasal bony deviations. Eleven patients with severe deviated nose who had been operated by the senior author from 2013 through 2016 were included in the study (follow-up period of 6-24 month). Intermediate short osteotomy was performed after medial and before lateral osteotomy. Surgical outcomes were assessed by another otolaryngologist based on review of pre- and post-operative (6 to 24 months after surgery) photographs. The post-operative outcome in terms of deviation correction was classified as excellent, good, fair, or no change. RESULTS Of all 11 cases, 6 (54.5%) were accepted as excellent, 4 (36.4%) as good, and 1 (9%) as no change. CONCLUSION Intermediate short osteotomy can be considered as a modification of intermediate osteotomy that eliminates nasal dorsal deviation more completely. This osteotomy is very simple and need only 1 to 2 minutes and use of this method is recommended for correction of severe deviated bony noses.

A Systematic Analysis of the Nasal Septum in Crooked Noses and Suggested Treatment Algorithm According to Preservation Rhinoplasty (PR) Principles

“…This method fundamentally serves to strengthen the middle nasal vault, and hence prevents postoperative collapse. It also proves immediately functionally better by broadening the angle of the internal nasal valve, thus increasing respiratory airflow [ 41 – 43 , 47 , 48 ]. However, the “Pisa Tower concept” [ 13 ] helps to understand that septoplasty procedures can be adapted to the requirements for the bony and cartilaginous surgical procedures according to their difficulties, leading to a straight nose with a straight septum and sufficient ventilation.…”