Open Roof Deformity Correction

The rocker and open roof deformity are discussed in previous portions of this article.

Open roof deformity correction. An open roof deformity exists after bony hump removal without proper medialization of the nasal bones. 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. 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. An open roof deformity makes the nose appear excessively wide.

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

In the senior author s experience the overall dissatisfaction rate in patients with deviated nose was up to 20 in his series. Especially in patients with type v deviation the correction of linear deviation was the most dissatisfactory in surgical outcome. The open roof deformity results from the failure to close the space between the lateral nasal bones after hump removal. Osteotomies fractures may be necessary and on lay grafts may be used to close the gap between the nasal.

Verification by palpation is paramount after any dorsal removal intent. Patients may present with depressed skin stuck down to intranasal mucosa and a persistently wide nose. Thereafter cartilaginous hump can be reduced with scalpel and bony hump can be rasped or in the case of being larger removed with osteotome. Correction of this deformity requires closing the space between the lateral nasal bones.

Correction involves ensuring an undeflected nasal septum and recreating appropriate osteotomies that are stabilized medially. The use of bone dust to correct the open roof deformity in. Finally under direct vision osteotomies can be performed to close the open roof deformity fig. The lateral osteotomies are performed to close an open roof deformity or to narrow the nasal pyramid.

With the former the osteotome is used to make a bony cut along the nasal facial groove. An additional cause of open roof deformity is overzealous nasal packing which can splint the nasal bones in a lateralized position. One of the most common issues present in patients seeking revision rhinoplasty is the inverted v deformity.