Open Roof Deformity Correction

One of the most common issues present in patients seeking revision rhinoplasty is the inverted v deformity.

Open roof deformity correction.

An open roof deformity makes the nose appear excessively wide. It depends on how low or high the nasal bones are positioned. This refers to an upside down v shaped indentation between the end of the nasal bones and the start of the upper lateral cartilages along the top of the bridge. How to correct it.

The lateral osteotomies are performed to close an open roof deformity or to narrow the nasal pyramid. An open roof deformity exists after bony hump removal without proper medialization of the nasal bones. A cross section of the nose will appear as a trapezoid instead of the more natural triangular configuration. Correction involves ensuring an undeflected nasal septum and recreating appropriate osteotomies that are stabilized medially.

With the former the osteotome is used to make a bony cut along the nasal facial groove. The open roof deformity results from the failure to close the space between the lateral nasal bones after hump removal. This approach is attractive from aesthetic and functional aspects because it accomplishes dorsal reduction correction of the open roof deformity preservation of the middle vault and restoration of the natural contouring of the nasal dorsum while obviating the need for osteotomies. Correction of this deformity requires closing the space between the lateral nasal bones.

An additional cause of open roof deformity is overzealous nasal packing which can splint the nasal bones in a lateralized position. Osteotomies fractures may be necessary and on lay grafts may be used to close the gap between the nasal. The use of bone dust to correct the open roof deformity in. Thereafter cartilaginous hump can be reduced with scalpel and bony hump can be rasped or in the case of being larger removed with osteotome.

Verification by palpation is paramount after any dorsal removal intent. Typically the nasal skin grows or droops and vertical lines or depressions start to appear. Finally under direct vision osteotomies can be performed to close the open roof deformity fig. Patients may present with depressed skin stuck down to intranasal mucosa and a persistently wide nose.

Normally a low to. A persisting deviation of the perpendicular plate of the ethmoid bone prevents medialization of the nasal bone usually unilaterally. This may be performed with either the linear single cut or the perforating technique.