Surgical correction of severely deviated or “saddle” noses poses specific problems
that are often difficult to resolve because of the complexity of the deformities,
particularly those of the septum. Four steps are necessary: (1) the deformations must
be skeletonized and visualized by a perfect extramucosal dissection and maxillary-premaxillary
approaches; (2) the septum must be mobilized by resection of the osteocartilaginous
chondrovomerine callus, after which it is possible to carry out the septum as long
as the mucosa is not torn; (3) the angulations must be corrected carrying out discontinuous
cartilaginous incisions; and (4) the structures must be stiffened. Polydioxanone (PDS®) struts provide a neat solution to the issue of the reconstruction of a plane and
sufficiently stiff septum.
Traumatic noses - septoplasty - rhinoplasty - polydioxanone
