Risk Factors of Saddle Nose Deformity after Septoplasty

Choi, Gwan; Kim, Joo Yeon; Kim, Yeong Joon; Jang, Seong Uk; Jo, Joo Wan; Kwon, Jae Hwan

Abstract

BACKGROUND AND OBJECTIVES
Surgeons operate carefully to prevent nasal deformity during septoplasty, however, rarely unfavorable esthetic outcomes such as saddle nose deformity may occur. This study was designed to investigate patient factors associated with post-septoplasty saddle deformity.
SUBJECTS AND METHOD
Of 588 patients who underwent endonasal conservative septoplasty from Jan. 2011 to Dec. 2014, a total of 183 patients were enrolled in this study group after exclusion. Patients were divided into two groups: 12 patients who developed saddle deformity of nasal dorsum after septoplasty belonged to the 'deformity group', and the remaining 171 patients were enrolled in the 'non-deformity group'. We investigated preoperative external nose status, patterns of septal deformity, dorsal septal thickness, the angle of axial and coronal deviation of caudal sepum on CT scan.
RESULTS
The postoperative saddle deformity was not found to correlate with the location of the most deviated septum and the thickness of dorsal septum (p>0.05). 50% of patients in the deformity group had saddle nose preoperatively, showing statistical differences between the two groups (p=0.000). 75% of patients in the deformity group had severe deviation at the most deviated site, also showing a significant difference compared with the non-deformity group (p=0.011). The axial and coronal deviation angle of caudal septum in the deformity group were significantly increased compared with the non-deformity group (p<0.01).
CONCLUSION
The preoperative saddle nose, severity of deviation, and angle of axial and coronal deviation of caudal septum are all possible risk factors of postoperative saddle deformity. We recommend that the surgeon should check these factors before septoplasty to prevent postoperative saddle nose deformity.