Definition
An inverted V deformity refers to the appearance of the nose on frontal view due to
inferomedial collapse of the upper lateral cartilage (ULC) often following overresection of the ULC or failure to secure the ULC to the septum.
Description
This is a mid-third deformity with an overly narrow middle nasal vault with disruption of the normal brow-tip aesthetic line. The nose is often described as having a “washed-out” appearance due to the prominence of the caudal edges of the nasal bones.
Anterior rhinoscopy reveals inching of the internal nasal valve with an associated decreased valve patency and premature collapse of the ULCs upon inspiration
Performed through an endonasal or external approach. This involves:
Definition
Saddle-nose deformity is an abnormally concave profile of the nasal dorsum due to the loss of nasal support. It most commonly occurs following trauma, in large septal perforations or post-operatively by over-resection of the septal cartilage or disruption of septal attachments.
Description
Supratip depression and widening of the middle vault. Collapse of the internal and external nasal valves with decreased projection and retraction of the columella.
These can be complex to correct and usually performed through an external approach. The principles and options include:
Definition
Pollybeak describes a supratip fullness resembling a parrot’s beak, leading to underrotation of the tip. This most commonly occurs post-operatively and is believed to be due to over-resection of the nasal dorsum resulting in supratip dead space and the formation of excess scar tissue that 'pushes' the tip downwards leading to underrotation. This can also occur due to under-resection of the nasal dorsum.
Description
Supratip fullness with underrotation of the tip.
This depends on the underlying cause of the pollybeak deformity.