Saddle Nose: Symptoms, Causes, Treatment

What are the symptoms of saddle nose?

Saddle nose, characterized by a depression or collapse of the nasal bridge, presents with several noticeable symptoms:

• Depressed Nasal Bridge: The most apparent symptom is a noticeable indentation or collapse at the bridge of the nose, giving it a “saddle-like” appearance. This can occur due to a loss of cartilage and sometimes bone in the nasal structure.
• Altered Nasal Shape: The overall shape of the nose may appear altered or flattened, with a prominent dip at the nasal bridge.
• Breathing Difficulties: Depending on the extent of the deformity, there may be nasal obstruction or difficulty breathing through the nose if the internal nasal passages are affected.
• Nasal Deformity: The change in the appearance of the nose can be accompanied by a crooked or uneven appearance, affecting both the aesthetic and functional aspects of the nose.
• Nose Pain or Discomfort: In cases where the deformity is associated with trauma or underlying conditions, there might be pain or discomfort in the nasal area.
• Secondary Symptoms: If saddle nose results from or contributes to other conditions, such as chronic sinusitis or infections, additional symptoms related to those conditions may also be present.

Saddle nose can result from various causes, including trauma, certain medical conditions like Wegener’s granulomatosis or leprosy, and congenital abnormalities. If you suspect saddle nose, it’s important to seek medical evaluation to determine the underlying cause and appropriate treatment.

What are the causes of saddle nose?

Saddle nose is characterized by a depression or collapse of the nasal bridge and can be caused by several factors:

• Trauma: Injury to the nose, such as from an accident or physical trauma, can damage the nasal cartilage and bones, leading to a saddle nose deformity. This is one of the most common causes.
• Infections: Certain infections, such as syphilis or leprosy, can lead to destruction of nasal tissues and cartilage, resulting in a saddle nose appearance. Wegener’s granulomatosis (now known as granulomatosis with polyangiitis) is another infection-related cause that can lead to nasal deformities.
• Chronic Inflammatory Conditions: Conditions like granulomatosis with polyangiitis and other systemic inflammatory disorders can damage the nasal cartilage and result in a saddle nose.
• Congenital Abnormalities: In some cases, saddle nose may be present from birth due to congenital issues with the development of nasal structures.
• Rhinoplasty Complications: Surgical procedures to alter the nose, particularly rhinoplasty, can sometimes result in saddle nose as a complication if there is significant damage to the nasal support structures or if the surgery is not properly managed.
• Drug Use: Chronic use of certain drugs, such as cocaine, can lead to the destruction of nasal tissues and cartilage, resulting in a saddle nose deformity. The drug’s effect on the nasal septum and surrounding structures can cause collapse and indentation.
• Tumors: Rarely, tumors or other growths in the nasal area can erode the nasal cartilage and bones, leading to a saddle nose appearance.

Identifying the underlying cause of saddle nose is important for determining the most appropriate treatment or management plan. If you suspect saddle nose, consulting with a healthcare provider or specialist is recommended for evaluation and diagnosis.

What is the treatment for saddle nose?

Treatment for saddle nose aims to address both the cosmetic and functional aspects of the condition. The approach depends on the underlying cause and the severity of the deformity. Here’s an overview of common treatment options:

Surgical Reconstruction:

• Rhinoplasty: Surgical reconstruction, or rhinoplasty, is the primary treatment for correcting saddle nose deformities. This procedure involves reconstructing the nasal bridge using grafts or implants to restore its shape and support. The type of graft used may include cartilage from the patient’s own body (such as from the ear or rib) or synthetic materials.
• Septoplasty: If the saddle nose is associated with nasal obstruction or a deviated septum, septoplasty may be performed in conjunction with rhinoplasty to improve breathing and correct the alignment of the nasal septum.

Medical Management:

• Treating Underlying Conditions: If saddle nose is caused by an underlying condition such as an infection or inflammatory disease, treating the primary condition is essential. This may involve medications like antibiotics for infections or immunosuppressive drugs for inflammatory diseases.
• Managing Drug-Related Damage: If the saddle nose results from drug use, particularly cocaine, addressing substance abuse is crucial. This might involve counseling and addiction treatment programs to prevent further damage.

Rehabilitation and Follow-Up:

• Post-Surgery Care: After surgical reconstruction, follow-up care is necessary to ensure proper healing and to monitor for any complications. This may include regular check-ups with the surgeon and adherence to post-operative care instructions.
• Physical Therapy: In some cases, physical therapy may be recommended to address any functional issues related to nasal breathing or to support recovery after surgery.

Cosmetic and Prosthetic Solutions:

• Nasal Prosthetics: For patients who are not candidates for surgery or prefer a non-surgical approach, nasal prosthetics can be used to improve appearance and function. These are custom-made devices that can be fitted to the nose to provide a more natural appearance.

The choice of treatment should be guided by a thorough evaluation by a healthcare provider or specialist, who can assess the underlying cause of the saddle nose and recommend the most appropriate intervention.