Saddle nose is a concave nose that can result in breathing difficulties and recurring respiratory infections. It can be caused by genetics, infections, inflammation, drug abuse, trauma, or previous nasal surgery. Treatment involves identifying the cause and performing rhinoplasty or medical intervention.
A saddle nose is a nose with a concavity, resulting in relatively little nasal length, nasal support, and aesthetics. In addition to giving the nose an unsightly pug-nosed appearance, saddle nose symptoms include nasal obstruction, difficulty breathing, and recurring respiratory infections. Saddle nose treatment involves knowing the cause, determining the degree of saddle nose, and performing rhinoplasty.
The causes of saddle nose are genetic, infectious, inflammatory, malignant, autoimmune, drug-induced, or associated with trauma. Infectious diseases, such as leprosy and syphilis, can also cause nasal congestion. When an infected mother transmits syphilis to her fetus during pregnancy, the baby will have a condition called congenital syphilis, which is characterized by the presence of a saddle nose, blunt and serrated upper incisors, inflamed cornea, protruding lower jaw, and short upper jaw. jaw. An infant or child with congenital syphilis may also have swollen knees and saber shinbone, which refers to a malformed and anteriorly arched shinbone.
Inflammatory and autoimmune causes include relapsing perichondritis and Wegener’s disease. In relapsing perichondritis, destruction of the cartilaginous structures of the nose, ears, heart valves, eyes, windpipe, skin, and blood vessels occurs. In Wegener’s disease, small to medium-sized blood vessels become inflamed and destroyed by the body’s immune cells. Aside from a saddle nose deformity that results from destruction of the nasal septum, people with Wegener’s disease have recurring nosebleeds and respiratory infections, which can be accompanied by neurological, kidney, and heart problems.
A known cause of saddle nose is drug abuse. Smelling cocaine or heroin can lead to holes or perforations in the nasal septum, resulting in stuffiness of the nose. Malignant causes include a type of T-cell lymphoma called lethal midline granulomatous disease. Malignant tumors of the paranasal sinuses can also metastasize to the nose, leading to loss of nasal structural integrity and consequent deformity of the saddle.
Trauma or previous nasal surgery can also lead to this type of deformity. Direct trauma can destroy the bony and/or cartilaginous part of the nasal septum. When it is caused by trauma, infection and abscess formation can follow, leading to the need for more intensive treatment. Previous rhinoplasty or nasal surgeries can also lead to this deformity.
Some cases of saddle nose require medical intervention based on the underlying cause. Treatment with penicillin is needed for syphilis, while corticosteroids and immunosuppressants are needed for Wegener’s granulomatosis. Surgery is performed based on patient preference, the underlying cause, and the presence of symptoms. When there is nasal obstruction or septal perforation, it is best to do nasal reconstructive surgery or rhinoplasty.
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