Nasal deviation management of a group of Egyptian patients

Abstract Introduction Among races, the Egyptian nose is an example of the mixed ethnic nature in terms of its anatomy and morphology. The predominant character in Middle Eastern noses is thick skin and weak cartilages, when compared with those of White noses. The study aimed to classify a group of Egyptian patients with nasal deviation and to develop a convenient algorithm for their management. This study aimed to compare spreader grafts versus clocking sutures for correcting dorsal nasal deviation. Also, it aimed to compare septal extension grafts and columellar struts versus the swinging door technique for correcting caudal nasal deviation. Material and methods In this study, a group of Egyptian patients with a deviated nose was classified according to the orientation of the nasal bony and cartilaginous units relative to the midline. Spreader grafts and clocking sutures were used for the correction of a deviated dorsal cartilaginous septum. In contrast, the swinging door technique, combined with a columellar strut and septal extension graft, was one of the two techniques used for caudal septal correction. Assessment was conducted using Cottle’s test, NOSE score, GIMP software, and Computed Tomography. Results The study was conducted on 60 patients (36 males and 24 females), with a mean age of 25.7 years (range, 16–40 years). Bilateral bony osteotomy was done for all cases. Type I of nasal deviation was the most common (30%), while the least common type was type V (10%). Correction of the deviated angle was significant ( P  < 0.001). The outcome of spreader grafts was superior to that of clocking sutures in cases of severe deviation. Likewise, the septal extension graft was better for caudal septum correction. Conclusion The Egyptian nose exhibits distinctive features, including thick skin and a weak cartilaginous framework. Of the five types of nasal deviation, type I was the most common type (30%). The angle of nasal deviation showed significant postoperative improvement ( P value < 0.001). Level of evidence IV