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Individuals who are not satisfied with the appearance of their nose often seek out nose surgery, or rhinoplasty, to address their aesthetic concerns. A popular cosmetic surgery procedure, rhinoplasty can bring harmony and balance to an individual’s facial features. However, in some cases, nose surgery may be recommended to alleviate functional issues related to the nose and nasal passages. There are often functional issues that can coincide with or influence the aesthetic nasal appearance as well.
While cosmetic rhinoplasty is limited to external modifications, functional rhinoplasty addresses conditions that interfere with nasal function. Complications related to nasal function often can arise from internal issues that sometimes may have little or no correlation with outward appearance. On the other hand, some functional issues such as a nasal fracture, deviated septum (depending on where it is located), and valve collapse will have a predictable effect on nasal appearance. Some common causes for functional impediments include:
- Deviated nasal septum
- Nasal fracture (broken nose)
- Nasal valve stenosis (valve narrowing)
- Enlarged or overactive turbinates
- Septal perforations (a hole or puncture in the nasal septum)
Irregularities in the internal structure can be a congenital condition, present at birth, or may develop as the result of a surgery, injury or trauma, and often lead to problems with nasal breathing. Because of their negative impact on health and quality of life, functional issues are generally considered medical conditions.
Evaluation and Diagnosis of Functional Problems
Due to the complex and nuanced nature of functional problems, it is essential that a proper diagnosis is made of the condition before any treatment plan is pursued. Problematic breathing conditions can be influenced by several factors and, if a contributing cause is overlooked or not fully understood, it can lead to a misdiagnosis. Moreover, due to anatomical diversity, the most complete diagnosis will vary case by case. Drs. Litner and Solieman have dedicated much of their careers to developing advanced techniques for the diagnosis and surgical correction of internal nasal issues.
During the preoperative assessment, a medical history will be taken and the patient will be asked to provide detailed information about the onset or worsening of the problem, past surgeries, injury and/or trauma to the nose.
As part of the physical examination, the exterior and the interior of the nose will be fully evaluated. Drs. Litner and Solieman will observe the motion of the nose during restful breathing and more vigorous respiration. This allows Drs. Litner and Solieman to gain insight into the functioning of the nasal passages, as well as note what anatomical characteristics are contributing to the obstruction of breathing. For example, tip morphology (such as the drooping of the nasal tip), may exacerbate functional issues. For an assessment of the interior of the nose, rhinoscopy allows Drs. Litner and Solieman to fully visualize the septum, the inferior turbinates, and the internal nasal valve. As needed, additional diagnostic tests are performed to further delineate potential sources for functional problems.
Once Drs. Litner and Solieman understand the scope of the problem and have ruled out contributing factors such as allergies or chronic sinus infections, they can determine the best approach to correcting the problem through functional rhinoplasty.
Depending on the underlying problem, a variety of surgical techniques can be deployed during a functional rhinoplasty. For example:
- In cases where a patient has a deviated, or offset septum, septal reconstruction, or septoplasty, can be performed to straighten the septum and facilitate better nasal respiration. If the problem is due to a fractured or broken nose, functional rhinoplasty procedure can repair the nasal bones by straightening the bones and any associated septal deflection or valve issue. In cases where trauma to the nose has compromised the external appearance of the nose, Drs. Litner and Solieman can restore the nose during the same procedure
- If a patient presents with a septal perforation, grafting techniques may be used to reconstruct the septal wall.
Functional rhinoplasty can alleviate a range of problems that lead to discomfort and improper breathing. Because breathing problems can contribute to sleep apnea and increased risks to overall health, those with severe breathing problems and/or chronic infections should seek a medical diagnosis.