title: [Twisted noses].
abstract: Correction of a twisted or crooked nose can be very complex and require the use of a broad range of surgical techniques. Patient needs are often mixed--aesthetic and functional--particularly in post-trauma cases. The quality of postoperative breathing is therefore as important as correction of the nasal deviation. Extracorporeal septoplasty or spreader grafts are very effective not only in correction of the nasal pyramid deformation, but also in resolution of functional respiratory issues. Reconstruction and proper support of the septum are necessary components for a straight nose. Aesthetic deformation can be difficult to correct owing to the memory of the bone and cartilage. Although minor deformations can be corrected with simple techniques, a more aggressive procedure is often necessary in the most complex cases. Despite attempts to correct deformation thanks to the various techniques described here, a postoperative deviation can persist. Preoperative discussion is very important and enables the surgeon to explain to the patient that it is very difficult to obtain a perfectly straight nose.
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Thomassin
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France. Electronic address: thomas.radulesco@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Radulesco
authors.affiliation: Service de chirurgie plastique, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Bardot
mesh_terms: D002356:Cartilage / Q000637:transplantation; D054893:Cone-Beam Computed Tomography; D004954:Esthetics; D006801:Humans; D015508:Nasal Obstruction / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery; D009666:Nose / Q000002:abnormalities*; D009667:Nose Deformities, Acquired / Q000175:diagnosis / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D025363:Rhinomanometry; D012225:Rhinoplasty / Q000379:methods*
keywords: Déviation septale; Nez dévié; Osteotomies; Ostéotomies; Rhinoplastie; Rhinoplasty; Septal deviation; Spreader grafts; Twisted nose