title: Management of post-traumatic combined deviated and saddle nose deformity.
abstract: CONCLUSIONS
  Establishing a straight and firm septum supporting the overlying nasal structures is the most important step in correcting the post-traumatic combined deviated and saddle nose.
  
  
  OBJECTIVE
  To present a surgical algorithm and key maneuvers that were successfully applied in the correction of post-traumatic combined deviated and saddle nose deformity.
  
  
  METHODS
  Twenty-five patients who had undergone primary rhinoplasty for a post-traumatic combined deviated and saddle nose were included. The patterns of deformity, surgical maneuvers, surgical results, and complications were analyzed using retrospective chart review, telephone interview, and preoperative and postoperative photographs.
  
  
  RESULTS
  Three distinct groups undergoing different techniques to correct the deformity were noted. Eighteen patients (72%) with intact septal support were treated by straightening the nose and septum followed by simple onlay grafts. Five patients (20%) with loss of septal support needed septal reconstruction. In two patients (8%) showing deviation, generalized saddling, and loss of septal support, a dorsal graft integrated to an extended columellar strut was performed, bypassing the major septal reconstruction. The key maneuvers for correction were dorsal onlay graft (100%), septoplasty (92%), and bilateral osteotomies (84%). No major complications were found. Objective evaluation showed complete correction of the deviation and saddling in 76%.
authors.affiliation: Department of Otorhinolaryngolgy, Seoul National University Hospital, Seoul, Korea.
authors.forename: Tae-Bin
authors.initials: TB
authors.lastname: Won
authors.forename: Jae-Goo
authors.initials: JG
authors.lastname: Kang
authors.forename: Hong-Ryul
authors.initials: HR
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055171:Nasal Cartilages / Q000637:transplantation*; D009300:Nasal Septum / Q000293:injuries / Q000601:surgery*; D009667:Nose Deformities, Acquired / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult