Post-traumatic rhinoplasty with significant deviation.
This patient sustained a substantial trauma (sports-related, during intensive boxing activity), which resulted in a marked deformity as well as a very significant respiratory obstruction. Here too, CT imaging is an essential tool to assess the precise condition of the nasal bones and the septum. In the frontal view, the deviation of the nasal pyramid is evident, while in the profile view there is also a saddle deformity caused by septal collapse. The three-quarter view very clearly demonstrates the asymmetry and deviation. It is important to note how critical it is, in the postoperative assessment of rhinoplasty performed on deviated noses, to examine both three-quarter views correctly.

The procedure required a complete extracorporeal septoplasty, but septal availability was sufficient and did not necessitate costal cartilage harvesting. In practice, the septum is carefully reassembled on the back table and repositioned in its anatomical location. The use of electric and piezo-electric burrs/rasps allows for great precision in remodeling and repositioning the nasal bones, which were grossly asymmetric. Adequate dorsal height is then provided by the use of a DCF graft (Diced Cartilage Fascia: cartilage, also harvested from the septum, diced into small pieces and wrapped in temporal fascia) of exact width and length.