The Effectiveness of Asymmetric Dorsal Preservation for Correction of I-Shaped Crooked Nose Deformity in Comparison to Conventional Technique

Abstract

Importance: Using asymmetric dorsal preservation (ADP) (pushdown technique for deviated side and letdown technique to the contralateral nondeviated side) is an alternative surgical method to correct osseocartilaginous deviation in crooked nose deformity.

Objective: Aim of this study was to evaluate whether ADP rhinoplasty is a good method to address I-shaped crookedness in comparison with conventional midvault deconstructing/reconstructing rhinoplasty.

Design, Setting, and Participants: This study was conducted between June 2017 and August 2019. Twenty-two consecutive patients' I-shaped crookedness was addressed with either ADP (n = 10) or conventional midvault techniques (n = 12). Patients were followed up at least for 6 months.

Main Outcomes and Measures: Pre- and postoperative frontal photographs and digital screen protractor was utilized for measurement of crookedness in a single-blinded manner. Surgical success were calculated and compared.

Results: In ADP group, mean angle of deviation was 10.2 +/- 3.7 degrees and 0.5 +/- 1.0 degrees pre- and postoperatively, respectively. In control group, mean angle of deviation was 9.5 +/- 1.8 degrees and 0.3 +/- 0.9 degrees pre- and postoperatively, respectively. Change in angle was statistically significant for both groups. Postoperative calculated mean success rate was 96.3 +/- 7.9% and 97.5 +/- 8.5% for dorsal preservation and control group, respectively. Eight out of 10 patients in dorsal preservation group and 11 out of 12 patients in the control group achieved the ideal angle of 0 degrees, hence had 100% postoperative surgical success.

Conclusions and Relevance: Utilization of dorsal preservation principles for correction of I-shaped crookedness presents as a promising and practical surgical alternative approach that should be in every rhinoplasty surgeon's armamentarium.