Nasal Open Roof Deformity

An open roof deformity makes the nose appear excessively wide.

Nasal open roof deformity. Hump removal frequently results in an open roof during rhinoplasty which is conventionally closed with lateral osteotomies. A space is formed when the nasal bones do not come together near the top of the nose. When a bump is made smaller the top of the bones is shaved or cut shorter to reduce the bump. It depends on how low or high the nasal bones are positioned.

The hump is removed with a scalpel essentially a slice of bone is taken away. On profile view a large dorsal hump causes the nose to look like it has a big bump. Moreover the election of the technique responds to surgeon s preference. How to correct it.

Notwithstanding the optimal method of nasal osteotomy remains controversial as evidenced by the variety of approaches with no consensus between authors. Osteotomies fractures may be necessary and on lay grafts may be used to close the gap between the nasal bones. In this article the author presents a new and practical approach to fix the open roof deformity. However if the patient has a narrow bony vault lateral osteotomies are problematic.

Open roof deformity the nasal bones are not so much like a pyramid but more like an arched covered bridge or tunnel. After the bone is sliced away the nose looks great on profile view. An open roof deformity exists after bony hump removal without proper medialization of the nasal bones. But eight months later a visible dent appeared in the bridge of her nose known as an open roof deformity.

When the lateral segments fail to align with the septal dorsum following osteotomies a gap which may be visually and palpably obvious results. The best way to explain an open roof deformity is to start by explaining hump reduction rhinoplasty. A keen knowledge of the normal nasal anatomy and physiology is required to recognize abnormalities and to develop a treatment plan for each individual patient that appropriately addresses both cosmetic and functional concerns. Nasal osteotomies are a cornerstone step for closing an open roof deformity after dorsal hump surgery.

Patients may present with depressed skin stuck down to intranasal mucosa and a persistently wide nose. An additional cause of open roof deformity is overzealous nasal packing which can splint the nasal bones in a lateralized position. Posttraumatic nasal deformity is a complex problem that requires astute preoperative assessment and nasal analysis. Typically the nasal skin grows or droops and vertical lines or depressions start to appear.