Residual Deformities of the Cartilaginous Framework

Abstract

Deformities of the cartilage are often more difficult to correct than those of the bone. External deviation of the nose in the lower part after rhinoplasty may be due to deviations of the dorsal border of the septal cartilage, forming a C- or S-shaped curve. I classify deflections of the nose as: (1) deformities restricted to the external nasal skeleton, (2) deformities of the inner skeleton, and (3) deformities affecting both. All three categories can be encountered in postrhinoplastic deformities. In the first and third categories it is necessary to bring the displaced nasal bone into the normal position by means of the usual osteotomies and by paramedian wedge resection on the side where the nose is too wide. The deflected nose can have a residual hump. This hump then has to be removed in the usual way, assuring the same asymmetrical resection of a strip of bone on the flatter side of the bony pyramid, as for simple crooked nose (see Chap. 22).