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Nasal Deviation and Facial Asymmetry in Patients Undergoing Rhinoplasty.

BACKGROUND: Existing literature conflicts on whether nasal deviation is primarily attributable to trauma or the result of asymmetric facial development.

OBJECTIVES: Establish the prevalence of nasal trauma and facial asymmetry in patients undergoing rhinoplasty. Determine if a correlation exists between the laterality of facial asymmetry and nasal deviation.

METHODS: Retrospective review of patients who underwent primary rhinoplasty with the senior author over a 12-month period. Patient charts were reviewed and clinical photographs were analyzed.

RESULTS: 144 patients underwent rhinoplasty over the study period. 68 patients underwent revision rhinoplasty and were excluded. Of the 76 patients who underwent primary rhinoplasty, 9% reported prior nasal trauma, 68% had deviated nasal bones, 46% had deviated nasal tips, 70% had asymmetric midfaces, and 36% had deviated chins. In patients without prior trauma history, nasal bones were most commonly deviated towards the side of midface hypoplasia (53%, p=0.008). The nasal tip was most commonly deviated contralateral to the side of septal deviation (59%, p=0.001). There was no association between nasal bone and chin deviation. Nasal tip deviation was not associated with midface hypoplasia or chin deviation.

CONCLUSIONS: Nasal deviation is primarily driven by asymmetric facial growth rather than the result of nasal trauma.

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