Classification of Nasal Deviation

Abstract

Due to its central location, the nose plays a prominent role in addressing the central facial axis which helps at camouflaging a large proportion of facial asymmetry. It gives the standard norm to the facial expressions, any little nasal deviation result in conspicuous facial disharmony and are often attended by nasal airway disfunction. The nasal deviation causes a cosmetic deformity that is often disconcerting for patients. Nasal deviation carries considerable risk at the nasal airflow by increasing the nasal valve resistance at the level of mid vault and/or lower alar structures. The lack of objective measurement of the external nasal deviation puts the professions at risk of standardizing the severity of the deviation. It deprives the nasal plastic surgeons of having a common thought about the most likely convenient and available techniques for correcting the deviation in upper, middle, and lower thirds and nasal root as the grade of deviation is indicated. This work is licensed under Creative Commons Attribution 4.0 License OJOR.MS.ID.000509. Online Journal of Otolaryngology and Rhinology Volume 1-Issue 2 Citation: Abdul RS Juratli. Classification of Nasal Deviation. Online Journal of Otolaryngology and Rhinology. 1(2): 2019. OJOR.MS.ID.000509. DOI: 10.33552/OJOR.2019.01.000509. Page 2 of 5 Nasal Parts and its Aesthetic Lines The external nose is divided into 3 parts; upper, middle and lower thirds [2]. The upper is a bony structure made from the nasal spine of the frontal bone, two nasal bones, and the ascending or frontal process of the maxilla on both sides. The Middle third is a cartilaginous extension of the nasal dorsum consists from a combination of triangular septal cartilage on the middle, the upper alar cartilages on each side and little sesamoid cartilages on the basal connection with the nasal bony pyriform aperture and the lower attachment of the alar base. The lower third is a fibrofatty cartilaginous structure with a condensation of retaining ligaments, it is structured by the lower alar cartilages, caudal part of the nasal septum and the anterior maxillary nasal spine. Alar base stabilization and the anterior nasal spine suture technique are essential for achieving a stable midline anchor for ensuring long-term straight nasal alignment. The dorsal aesthetic line [3] (DAL), provides a thoroughfare between the radix and nasal tip, it is in the middle between the two brow-tip aesthetic lines (BTAL) (Figure 2).