Deformities of the External Nose

Causes and forms: Deformities may be congenital or traumatically acquired. Virtually any bony and
cartilaginous structures of the external nose may be affected. An accompanying septal deviation is present in many cases. The most common deformities are a crooked nose, humped nose, saddle nose, and broad nose, which may occur separately or in combinations.
Diagnosis: Besides inspection of the external nose, in which the affected cartilaginous and bony structures are identified, the diagnostic workup should include anterior rhinoscopy or endoscopy to evaluate the shape and position of the nasal septum. Photographic documentation should always be obtained preoperatively for medicolegal reasons.
Treatment: Since deformities of the external nose are frequently associated with intranasal changes, most cases have both a functional and an aesthetic indication for corrective surgery. The treatment of choice is “functional septorhinoplasty,” with correction of the nasal septum and external nose. In most cases the bony nasal skeleton has to be osteotomized at multiple sites in order to achieve the desired nasal shape and position. The humped nose additionally requires dorsal hump removal.
Saddle nose is corrected by filling the dorsal concavity with a cartilage graft taken from the septum,
auricle, or rib.