title: A different approach to the reconstruction of the stubborn crooked nose with a different spreader graft: nasal bone grafts harvested from the removed nasal hump.
abstract: BACKGROUND
  Correction of a crooked or deviated nose is a complex cosmetic and functional problem as well as a big challenge for the rhinoplasty surgeon. Although corrections using a wide range of surgical techniques to straighten the nose and maximize nasal function have been proposed, recurrence is very common because of cartilage memory and scar contracture. Therefore, to prevent recurrence and maintain the correction of the septum, a permanent support that is stable and strong with the ability to maintain its given shape after placement on one or both sides of the septum is needed.
  
  
  METHODS
  The author used a nasal bone graft. In this study, the concept and technique for correction of the crooked nose and the author's experience using it are presented.
  
  
  RESULTS
  This graft material was used for 12 patients with crooked noses (8 with C-type and 4 with S-type noses). During a mean follow-up period of 20 months (range, 12-36 months), there were no complications, recurrences, or extrusions. Functional evaluations were performed using a visual analog scale before surgery and 6 months after surgery. Patients were asked to score their nasal breathing on a scale ranging from 0 to 100. The mean preoperative value was 17.67% +/- 1.22% (range, 15-25%), and the postoperative value was 89.88% +/- 1.24% (range, 85-95%).
  
  
  CONCLUSIONS
  Use of nasal bone grafts as the spreader graft is a safe, effective, reliable, and permanent method for correction of the crooked nose. The author advises using this technique with nasal bone grafts for functional recovery and increased strength against further trauma or forces of scar contracture. This technique may prevent recurrence attributable to cartilage memory.
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Numune State Hospital, Numune Hastanesi, Plastik Cerrahi Klinii, Erzurum 25240, Turkey. ilterisemsen@hotmail.com
authors.forename: I M
authors.initials: IM
authors.lastname: Emsen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009295:Nasal Bone / Q000601:surgery* / Q000637:transplantation*; D009300:Nasal Septum / Q000002:abnormalities / Q000601:surgery / Q000637:transplantation*; D009666:Nose / Q000002:abnormalities* / Q000601:surgery*; D012119:Respiration; D012225:Rhinoplasty / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014182:Transplantation, Autologous