The Effect of Facial Asymmetry on Nasal Deviation

Abstract

The impact of facial asymmetry on nasal deviation is an accepted but poorly understood part of plastic surgery and rhinology training. Recently, an increased understanding of the specific structural issues underlying this deformity has led to improved surgical techniques and patient outcomes.

The Subalar Graft and Its Role in Nasal Tip Medialization and Improved Nostril Symmetry

“…Higher revision rates for these patients are typically cited, and persistent deviations often are seen. 3,6,7…”

“…The 3 main interventions to the foundation of the nose are subalar grafting techniques, advanced septoplasty techniques involving caudal mobilization, and perforating double lateral osteotomy techniques. 3,6,7 All 3 concepts have been previously presented in other publications. These techniques do not interfere with or prevent the use of other nasal modifications that an individual surgeon typically uses.…”

“…Previous studies have demonstrated a significant, nearly linear relationship between central maxillary hypoplasia and nasal axis deviation. 3,6 Based on these studies, those patients with significant facial asymmetry on preoperative assessment are typically treated using, at least in part, a subalar graft on the side of facial hypoplasia.…”

“…1 Until recently, there have been no significant quantifiable relationships between these findings, and analysis has been an extrapolation from the cleft lip model. 2,3 Surgical correction has been geared toward asymmetric suturing, structural grafting, or camouflage techniques on the nasal tip and midvault. This strategy of modifying the suprastructure of the nose has provided excellent but sometimes unpredictable or limited results in deviated nasal correction.…”

Histological and molecular characterization of the growing nasal septum in mice

“…Its resection interferes with midfacial growth (Moss et al, 1968; Sarnat & Wexler, 1967; Stenström & Thilander, 1970). Children with midfacial hypoplasia often present with nasal septum deviation, although the significance of this malformation is not understood (D’Ascanio et al, 2010; Kemble, 1973; Westreich et al, 2011). Because of its hyaline characteristics, nasal septum cartilage is being explored as source for autologous chondrocytes that can be used for articular cartilage repair (Mumme et al, 2016).…”