title: Asymmetrical nostril axis angle in the post traumatic nose.
abstract: BACKGROUND
  Nasal tip reconstruction is a challenging part of septorhinoplasty in post-traumatic patients. Aesthetic appearance of the nose is dependent on adequate tip definition, projection and rotation. Our aim is to establish if caudal septal dislocation (secondary to fracture or subluxation) is a significant factor in causing asymmetry in nostril axis angle (NAA) to effect surgical intervention. In addition, to assess if there is an association between the side of dislocation and the magnitude of NAA.
  
  
  METHODS
  Photographic assessment of NAA was measured in a study group of 26 patients with caudal dislocation of the septum and a control group of 26 patients without caudal septal dislocation. All 52 patients were awaiting a septorhinoplasty procedure due to nasal trauma.
  
  
  RESULTS
  Caudal septal dislocation causes a mean difference in NAA of 7.95o compared to 1.38o difference in the control group. We also found there is a greater degree of upward tip rotation on the side of the dislocation resulting in a larger NAA.
  
  
  CONCLUSIONS
  Caudal dislocation of the septum causes a significant asymmetry in NAA, with a greater degree of rotation on the side of the dislocation. We should be aware of this fallacy prior to surgery.
authors.affiliation: Department of Otolaryngology, Southern General, Glasgow, Scotland, UK. iansmillie@doctors.org.uk
authors.forename: I
authors.initials: I
authors.lastname: Smillie
authors.forename: A
authors.initials: A
authors.lastname: Sil
authors.forename: R
authors.initials: R
authors.lastname: Haddock
authors.forename: N
authors.initials: N
authors.lastname: Balaji
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D009300:Nasal Septum / Q000293:injuries* / Q000601:surgery*; D009666:Nose / Q000293:injuries* / Q000601:surgery*; D009667:Nose Deformities, Acquired / Q000601:surgery*; D010781:Photography; D012225:Rhinoplasty / Q000379:methods*; D018709:Statistics, Nonparametric