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Nasal Congestion caused by Trauma to the Nose, an ENT expert’s solution_Rhinoplasty Korea

최종 수정일: 9월 24일


Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today, we will introduce the case of a patient who visited our clinic after developing nasal congestion and shape deformation following trauma to the nose.


This patient had been in an accident a month before, in which she had received trauma to her nose that lead to developing nasal congestion and shape deformation, which is the reason she came to our hospital.


Patient’s Medical Record


  • 7 years before: tip plasty using the septal cartilage.

  • One month later, someone impacted her nose with an elbow.

  • After the accident, she developed symptoms of nasal congestion and shape deformation.


Preoperative Design Consultation












Frontal view:

  • The right side of the nose tip was tilted.

  • Noticeable nostril asymmetry.

  • Visible nostrils.


Side profile view:

  • Droopy nose tip

  • Bumpy nasal dorsum

  • Pointy-looking nose tip


45-degree view:

  • The nose tip looks upturned while also being droopy


Nostrils:

  • Columella tilted to the right side.

  • Nose tip tilted to the right side.

  • Noticeable nostril asymmetry.


CT findings:

















  • The left side of the septal cartilage was tilted (septal deviation)

  • Suspected fracture of the septal cartilage due to the trauma


Surgical Plan

To solve these complex issues, we came up with the following surgical plan:


  • Septal correction and reconstruction

  • Septal graft extension using donated rib cartilage.

  • Correction of the bent nose tip

  • Raising the nose bridge (non-prosthetic)

  • Nasal bone asymmetry correction through a lateral osteotomy.


Before and After Surgery Photos

  • The nose tip that was tilted to the right side was centered in the middle.

  • Great improvement of the nostril asymmetry.

  • Lowered the exposure of the nostrils.


  • The droopy nose tip was naturally elevated.

  • The bumpy nasal dorsum was made smooth.

  • Improvement of the condition of the pointy nose tip into a softer shape.


  • The droopy and upturned nose tip became raised in a natural-looking manner.

  • Harmony improvement of the overall nose shape.

  • The columella that was tilted to the right side was adjusted to the center.

  • Symmetry improvement of the bent nose tip.

  • Visible improvement of the nostril asymmetry.


After Surgery Table Photos













Overview


This case is about solving functional issues and shape deformation that occured due to trauma at the same time. There are some noteworthy points about this case as follows:


  • Importance of an accurate diagnosis: definite diagnosis of septal cartilage fracture and deviation through a CT scan.

  • Functional and cosmetic balance: improvement of the nasal congestion at the same time that a natural nose shape was created.

  • Non-prosthetic rhinoplasty: As the patient had requested, we obtained natural and safe results using only autologous tissue.

  • Closed rhinoplasty approach: successfully performed a complex reconstructive surgery without leaving external scars.



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