Cartilaginous saddle nose: Deformity and reconstruction

The saddle nose deformity represents one of the most challenging complications of nasal trauma. Optimal management requires careful preoperative analysis and thoughtful surgical planning. The surgeon must make the mental and philosophical commitment to address the difficult cosmetic components and the functional problems related to this deformity. Because this conditions result from disruptions of the nasal septum, its surgical correction mandates use of techniques that modify the septum, and it might require recon¬struction of the dorsal-caudal strut. By understanding the three-dimensional anatomy of this L-shaped strut, how its relationship to the other structural components of the nose determines external nasal contour, and the techniques available to stabilize this structure into an optimal position, the surgeon can correct this difficult cosmetic problem effectively while maintaining the overall structural and functional integrity of the nose.Indications for nasal reconstruction must be tempered by patient selection, the surgeon’s experience, and the etiology of the deformity. Indications for surgery can be functional, aesthetic, or, most commonly, both.