Saddle-shaped nose: why and the mechanism of its formation

2021-01-26 12:00 AM

Destruction of the nasal septum or supporting cartilage. Previous direct or surgical trauma directly affects the structural integrity of the support leading to a collapse in the middle part of the nasal bridge

Falling the middle part of the bridge of the nose causes the nose to curl like a saddle.

Figure. Saddle-shaped nose

Reason

Common

Injury.

Real nose surgery before.

Less common

U grain of Wegener.

Recurrent Inflammation of multiple cartilages

Sarcoidosis - rare.

Crohn's disease - rare.

Cocaine use - rarely.

Congenital syphilis - rare.

Mechanism

Destruction of the nasal septum or supporting cartilage. Previous direct or surgical trauma directly affects the structural integrity of the support leading to a collapse in the middle part of the nasal bridge.

Wegener's granulomatosis is an autoimmune disorder characterized by granulomatous necrosis that affects the small blood vessels in the upper and lower airways. Although the pathogenesis of the pathogenesis is unclear, it is thought that it is the deposition of immune complexes or the immune response against autoantigens that damage blood vessels and surrounding structures. This change is due to the autoimmune destroying cartilage of the upper respiratory tract and nasal cartilage. In summary, the immune system also plays a role in cartilage destruction, especially ear cartilage and nasal cartilage. In Wegener’s granulomatosis, destroying the nasal cartilage makes the nose look like sitting still.

Meaning

This is a very valuable sign. If there is no previous trauma or surgery history, a careful examination should be done to determine the underlying cause. This symptom is found in 65% of patients with recurrent Inflammation of multiple cartilages, 9–29% in patients with Wegener's granulomatosis.