Absorbable Plate as a Perpendicular Strut for Acute Saddle Nose Deformities

Background Nasal pyramid fractures accompanied by saddle nose deformities are noteasily corrected by closed reduction. We used an absorbable plate as a perpendicular strut tosupport the collapsed “keystone area” and obtained good results.Methods Between September 2008 and June 2011, 18 patients who had nasal pyramidfractures with saddle nose deformities underwent surgery. Pre- and postoperative facialcomputed tomographic images and photographs were taken to estimate outcomes. Theoperative technique included the mucoperichondrial dissection of the nasal septum, insertionof an absorbable plate prepared to an appropriate length to support the “keystone area”, andfixation of the absorbable plate strut to the cartilaginous septum.Results Functional and esthetic outcomes were satisfactory in all patients. Eleven patientsassessed the postoperative appearance of the external nose as ‘markedly improved’ and 7patients as ‘improved’. The 5 surgeons scored the results as a mean of 4.5 on a 5-point scale.Conclusions The use of an absorbable plate as a perpendicular strut requires no additionalprocedures because the plate is gradually absorbed. The mechanical strength provided by abuttress between the “keystone area” and the maxillary crest lasts for a long time before thestrut is absorbed.