Abstract :
[en] Introduction and Aim: Crooked nose is a common term used for all deviations of the nasal axis from the midline, leading to both aesthetic and breathing issues. Predisposing factors are numerous. The goal of this study was to determine the anatomical structures involved in nose assymetry and their eventual relationship with childhood injury.
Methods: In this retrospective study, 70 septorhinoplasty patients with pre-operative crooked noses were assessed from 2015 to 2020. Demographic and clinical variables were collected, especially history of nasal injury in relation to pubertal growth spurt. Using each patient’s pre-operative imaging, frontal process of the maxilla, nasal bones, septal cartilage, perpendicular plate, vomer, crest of maxilla and lateral nasal wall (inferior and middle turbinates) were evaluated.
Results: In the childhood inujry crooked nose population (n=24), 17 (70.8%) had deviated frontal process of the maxilla, 15 (32.5%) deviated basal bones, 18 (75%) deviated crista maxillaris, 20 (83.3%) deviated septal cartilage and 10 (41.7%) deviated perpendicular plate. In the post-puberty trauma crooked nose population (n=28), 10 (35.7%) had deviated frontal process of the maxilla, 22 (78.6%) deviated nasal bones, 9 (32.1%) deviated crista maxillaris, 19 (67.9%) deviated septal cartilage and 10 (35.7%) deviated perpendicular plate. In the non-traumatic crooked nose population (n=12), 11 (91.7%) had deviated frontal process of the maxilla, 11 (91.7 %) deviated nasal bones, 8 (66.7%) deviated crista maxillaris, 10 (83.3%) deviated septal cartilage, 10 (83.3%) deviated perpendicular plate.
Conclusion: Deviated nose is more complex than just an asymmetric position of nasal bones. It involves the frontal process of maxillary bone, the nasal bones (length and position), the lateral nasal wall and the septum. History of childhood injury was associated to more complex deformities. A good understanding of these anatomical factors might help surgical planning.
