Nose deformity

Disease Description (Causes and Symptoms)

• Definition: A condition in which the nose deviates from the midline when viewed from the front and bends or tilts to one side (nasal deformity).
• Causes and pathophysiology:
  • Congenital: Imbalance in the development of cartilage and bone structure, cleft lip, etc.
  • Acquired: Trauma (fracture, cartilage damage), or the result of previous nasal surgery.
  • After trauma, swelling may make it difficult to immediately recognize the deviation; as the swelling subsides, the bent shape is often identified. If a fracture or deformity of the nasal septum (the partition inside the nose) is also present, the nose may sink or tilt laterally over time.
• Main symptoms:
  • Appearance-related: The nose appears bent to one side (cosmetic concern).
  • Functional: Narrowing of one or both nasal passages may cause nasal congestion and difficulty breathing.
  • Associated symptoms: Nosebleed, altered sensation (numbness), swelling and bruising (after trauma).

Treatment Methods

• Conservative treatment
  • Relief of swelling and pain immediately after acute trauma (cold compresses, pain relievers). Immediately after trauma, protect the nose and monitor its condition.
  • Surgery may be considered if there is no improvement with nonsurgical management and functional or appearance-related problems persist.
• Fracture reduction (acute)
  • Within 1–2 weeks after trauma (usually 7–14 days), relatively simple reduction of a nasal bone fracture (nasal bone reduction, closed reduction) is possible. After this period, the bones may become fixed in place.
• Corrective surgery (corrective rhinoplasty, including rhinoplasty)
  • The positions of the bone and cartilage are realigned and fixed. In some cases, the nasal bones are intentionally cut (osteotomy) and repositioned.
  • Septoplasty: Breathing is improved by removing part of or correcting the deviated cartilage of the nasal septum.
  • Use of implants or autologous grafts (rib bone or cartilage): Cartilage or bone grafting may be necessary in cases of severe S-shaped deformity or collapse (depression).
  • Anesthesia: General anesthesia is generally used, and hospitalization for 1–2 days may be necessary.
• Medication treatment
  • Postoperative pain control (pain relievers), antibiotics if necessary (depending on the surgery and wound condition), and treatment to reduce swelling.
• Recovery and lifestyle management
  • Outpatient visits and wearing postoperative protection (splint): Usually for about 1 week.
  • Swelling and bruising are severe in the early postoperative period (1–3 days); daily activities are possible after 1 week; appearance recovers within 2–3 weeks; final recovery of sensation and swelling takes several months (2–4 months or longer).
• Risk of complications
  • Infection, asymmetry, nasal septal perforation, persistent nasal congestion, altered sensation, and scarring (rarely).

Checklist Before an Outpatient Visit (Items to Bring and Example Questions)

• Items to bring
  • List of medications currently being taken (especially including anticoagulants, antiplatelet agents, and NSAIDs)
  • History of previous surgery and trauma (especially the date and circumstances of any nasal surgery or recent trauma)
  • Recently taken photographs (useful for comparison before and after the injury, if available)
  • Copies of previous test results (nasal X-rays, CT scans, nasal endoscopy findings, etc.)
  • Information about allergies, smoking, and alcohol-use habits
• Main items the medical staff may ask about (examples of questions for the patient to prepare in advance)
  • When and how did you injure your nose? (Date and time, circumstances)
  • On which side are nasal congestion or difficulty breathing more severe?
  • Have you had any bleeding or discharge (such as pus)?
  • Have you ever had nasal surgery before?
  • Are you currently taking any medications regularly (especially medications that affect blood clotting)?

Examples of General Questions to Ask the Doctor

• What is the cause of this condition, and is my nose functionally impaired?
• What results (improvement in appearance and breathing) can be expected from surgery or nonsurgical treatment?
• What risks (complications) are expected with surgery, and how likely are they to occur?
• What should I be careful about in daily life before and after surgery (such as stopping smoking and alcohol use or discontinuing medications)?
• What is the recovery period, and when can I resume normal activities (exercise, returning to work, etc.)?

Examples of Condition-Specific Questions

• In the case of a traumatic fracture: "Until when is fracture reduction (nasal bone reduction) possible? If it is already too late, what is the alternative treatment plan?"
• Regarding the nasal septum: "Is a septal deformity also present along with the nasal deviation? Is it necessary to undergo septoplasty (or resection) at the same time?"