Document Detail

Prevalence of occult nostril asymmetry in the oversized nasal tip: a quantitative photographic analysis.
MedLine Citation:
PMID:  21931084     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To objectively determine the prevalence of occult nasal base asymmetry in adults with wide nasal tips using a standard photographic editing program.
METHODS: We performed a retrospective observational study in a private practice, ambulatory care setting. The photographs of 100 randomly selected patients undergoing rhinoplasty who presented with excessive nasal tip width and no apparent nasal base asymmetry were evaluated for occult nostril asymmetry. Patients varied by ethnicity and sex and ranged in age from 16 to 40 years. We excluded patients with discrete nasal base asymmetry, crooked or twisted noses, caudal septal deviation, columellar tilt, a history of craniofacial trauma, or a history of nasal surgery. Measurements were obtained using a standard photographic analysis program.
RESULTS: On the basal view, the median percentage of asymmetry (95% confidence interval) was 4.91% (4.17%-5.66%); on the frontal view, 4.66% (3.68%-5.62%). On the basal view, 73% of noses were at least 2.5% asymmetric; on the frontal view, 67% (McNemar P = .53). On the basal view, 48% of noses were at least 5% asymmetric; on the frontal view, 50% (McNemar P = .74). On the basal view, 11% of noses were at least 10% asymmetric; on the frontal view, 20% (McNemar P = .11).
CONCLUSIONS: A large percentage of individuals presenting with excessive nasal tip width and no obvious alar size discrepancies have nasal base asymmetry. Moreover, nostril asymmetry is demonstrated from the frontal and basal views with reasonable consistency. In a small subset of study patients, occult nostril asymmetry exceeded 10% of the total nasal base width. We postulate that clinically significant nostril size discrepancies are hidden by excessive tip width, and we speculate that these nostril size discrepancies become more apparent after surgical refinement of the oversized nasal tip, thereby potentially leading to unexpected postoperative cosmetic imperfections and patient dissatisfaction. The apparent frequency of (occult) nostril asymmetry in patients with excessive nasal tip width underscores the importance of nostril size assessment in the preoperative aesthetic analysis. We offer a reliable and convenient method for objective analysis of nasal base symmetry.
Shari D Reitzen; Luc G T Morris; Richard E Davis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of facial plastic surgery     Volume:  13     ISSN:  1538-3660     ISO Abbreviation:  Arch Facial Plast Surg     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-09-20     Completed Date:  2012-01-18     Revised Date:  2012-09-24    
Medline Journal Info:
Nlm Unique ID:  100883500     Medline TA:  Arch Facial Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-5     Citation Subset:  IM    
Department of Surgery, Memorial Hospital, Miramar, FL 33029, USA.
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MeSH Terms
Facial Asymmetry / pathology
Nose / pathology*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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